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Clinical Evidence

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The evidence is in...

TRIGEN INTERTAN is a hip fracture cephalomedullary nail with 10 years of clinical data.

TRIGEN INTERTAN Evidence thumbnail 

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TAYLOR SPATIAL FRAME is a computer-assisted external circular fixator with 20 years of clinical data.

TSF Evidence thumbnail 

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The evidence is in!  Based on data from more than two-dozen published studies, the TRIGEN INTERTAN Intertrochanteric Antegrade Nail allows patients to experience:

  • Lower risk of implant failure and reoperation 4-5,8,13-15, 17,22,24-26, 28
  • Faster time to fracture union 5,8-9, 17,20,22-24,26,28
  • High return to pre-fracture status 5,8,12,17,22,24,26,28

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INTERTAN challenge 1




1. American Academy of Orthopaedic Surgeons. Hip fractures in seniors: a call for health system reform. Position Statement 1144. Rosemont, IL: 1999.
2. Baumgaertner M, Solberg B. Awareness of tip-apex distance reduces failure of fixation of trochanteric fractures of the hip. J Bone Joint Surg Br. 1997;79:969–971;
3. Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, Geweke JF, et al. The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am. J Epidemiol. 2009 Nov 15;170(10):  1290-9. doi: 10.1093/aje/kwp266.
4. Erez O, Dougherty PJ. Early complications associated with cephalomedullary nail for intertrochanteric hip fractures. The journal of trauma and acute care surgery. Feb 2012;72(2):E101-105.
5. Galli M, Ciriello V, Bocchino L, Gangemi NM, Peruzzi M, Marzetti E. Clinical and functional outcomes of internal fixation with intertrochanteric antegrade nail in older patients with proximal extracapsular femoral fractures. Eur J Trauma Emerg Surg. 2013/10/17 2013:1-6.
6. Hoffmann S, Paetzold R, Stephan D, Püschel K, Buehren V, Augat P. Biomechanical evaluation of interlocking lag screw design in intramedullary nailing of unstable pertrochanteric fractures. J Orthop Trauma. 2013;27(9):483-490.
7. Hsueh KK, Fang CK, Chen CM, et al. Risk factors in cutout of sliding hip screw in intertrochanteric fractures: an evaluation of 937 patients. Int Orthop. 2010;34:1273–1276;
8. Kim JW, Kim TY, Ha YC, Lee YK, Koo KH. Outcome of intertrochanteric fractures treated by intramedullary nail with two integrated lag screws: A study in Asian population. Indian J Orthop. Jul-Aug 2015;49(4):436-441.
9. Liu Y, Tao R, Liu F, Wang Y, Zhou Z, Cao Y, et al. Mid-term outcomes after intramedullary fixation of peritrochanteric femoral fractures using the new proximal femoral nail antirotation (PFNA). Injury 2010;41:810–7.
10. Ma KL et al. Proximal femoral nails antirotation, Gamma nails, and dynamic hip screws for fixation of intertrochanteric fractures of femur: A Meta-Analysis. 2014. Orthopaedics & traumatology: Surgery and Research 100, 859-866.
11. Magaziner J, Fredman L, Hawkes W, Hebel JR, Zimmerman S, Orwig DL, Wehren L. Changes in functional status attributable to hip fracture: a comparison of hip fracture patients to community dwelling aged. Am J Epidemiol. 2003; 157:1023-31.
12. Matre K, Vinje T, Havelin LI, et al. TRIGEN INTERTAN intramedullary nail versus sliding hip screw: a prospective, randomized multicenter study on pain, function, and complications in 684 patients with an intertrochanteric or subtrochanteric fracture and one year of follow-up. The Journal of bone and joint surgery. American volume. Feb 6 2013;95(3):200-208.
13. Mir HR, Edwards P, Sanders R, Haidukewych G. Iatrogenic displacement of minimally or nondisplaced intertrochanteric fractures during intramedullary fixation: incidence, potential etiologies, and clinical impact. Current Orthopaedic Practice. 2013;24(1):58-63.
14. Mir HR, Edwards P, Sanders R, Haidukewych G. Results of cephallomedullary nail fixation for displaced intracapsular femoral neck fractures. Journal of orthopaedic trauma. 2011;25(12):714-720.
15. Mundi S et al. Similar mortality rates in hip fracture patients over the past 31 years: A systematic review of RCTs. Acta Orthopaedica 2014; 85(1): 54-59.
16. Nayak A, Smithson I, Cooper S, Cox J, Marberry, S, Santoni BG, et al. Comparison of femoral head rotation and varus collapse between a single and integrated dual screw intertrochanteric hip fracture fixation device using a chair rise biomechanical model. Abstract presented at: Orthopaedic Trauma Association Annual Meeting; October 15-18, 2014; Tampa, FL, USA.
17. Ruecker AH, Rupprecht M, Gruber M, Gebauer M, Barvencik F, Briem D, et al. The treatment of intertrochanteric fractures: results using an intramedullary nail with integrated cephalocervical screws and linear compression. J Orthop Trauma 2009;23:22–30.
18. Rueger J, Moore C. Shortening of the femoral neck following peritrochanteric fracture. Bone Joint Sci. 2011 May;2(5).
19. Rupprecht M, Grossterlinden L, Ruecker AH, et al. A comparative biomechanical analysis of fixation devices for unstable femoral neck fractures: the Intertan versus cannulated screws or a dynamic hip screw. J Trauma. 2011;71:625–634
20. Sahin EK, Imerci A, K􀃍n􀃍k H, Karap􀃍nar L, Canbek U, Savran A. Comparison of proximal femoral nail antirotation (PFNA) with AO dynamic condylar screws (DCS) for the treatment for unstable peritrochanteric femoral fractures. Eur J Orthop Surg Traumatol 2014;24:347–52.
21. Serrano-Riera R, Blair JA, Downes K, Sanders R. Cephalo-medullary nail fixation of intertrochanteric fractures: are two proximal screws better than one? Abstract presented at: Orthopaedic Trauma Association Annual Meeting; October 15-18, 2014; Tampa, FL, USA.
22. Seyhan M, Turkmen I, Unay K, Ozkut AT. Do PFNA devices and Intertan nails both have the same effects in the treatment of trochanteric fractures? A prospective clinical study. J Orthop Sci. Nov 2015;20(6):1053-1061.
23. Tao R, Lu Y, Xu H, Zhou ZY, Wang YH, Liu F. Internal fixation of intertrochanteric hip fractures: a clinical comparison of two implant designs. Sci World J 2013;2013:1–8.
24. Wang Q, Yang X, He HZ, Dong LJ, Huang DG. Comparative study of InterTAN and Dynamic Hip Screw in treatment of femoral intertrochanteric injury and wound. International journal of clinical and experimental medicine. 2014;7(12):5578-5582.
25. Wu D, Ren G, Peng C, Zheng X, Mao F, Zhang Y. InterTan nail versus Gamma3 nail for intramedullary nailing of unstable trochanteric fractures. Diagnostic pathology. 2014;9:191
26. Wu Y, Watson JT, Kuldjanov D, Jackman J. Rotationally stable fixation for intertrochanteric hip fractures: the Intertan experience, surgical technique, and outcomes. Techniques in Ortho. 2014; 29;3:120–132
27. Yu J et al. Internal fixation treatments for intertrochanteric fracture: a systematic review and meta-analysis of randomized evidence. Nature Scientific Reports. 2015.
28. Zhang S, Zhang K, Jia Y, Yu B, Feng W. InterTan nail versus Proximal Femoral Nail Antirotation-Asia in the treatment of unstable trochanteric fractures. Orthopedics. Mar 2013;36(3):e288-294.
Disclaimer: The results of in vitro simulation testing have not been proven to predict clinical performance.


A systematic review of the literature found:

  • Consolidation rates for children in all three indications were 100%.
  • Consolidation rates for adults with acute trauma, non/malunion, and deformities were 99.2%, 100%, and 100%, respectively.
  • The majority of complications in adults (64.1%) and children (68.5%) were considered grade I, and did not require operative strategies to address.

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Figure 4:  Consolidation rates of TAYLOR SPATIAL FRAME for three indications in adults.  

TSF 20 year whitepaper figure 4

Figure 5:  Consolidation rates of TAYLOR SPATIAL FRAME for three indications in children.  

TSF 20 year whitepaper figure 5

Figure 8:  Rate of correction goals achieved with TAYLOR SPTAIAL FRAME for deformities in adults

TSF 20 year whitepaper figure 8 adults

Figure 8:  Rate of correction goals achieved with TAYLOR SPATIAL FRAME for deformities in children

TSF 20 year whitepaper figure 8 children

1. Ahearn N, Oppy A, Halliday R, et al. The outcome following fixation of bicondylartibial plateau fractures. Bone Joint J. 2014;96-B:956-962.
2. Alexis F, Herzenberg JE, Nelson SC. Deformity correction in Haiti with the TaylorSpatial Frame. Orthop Clin North Am. 2015;46:9-19.
3. Al-Sayyad MJ. Taylor Spatial Frame in the treatment of pediatric and adolescenttibial shaft fractures. J Pediatr Orthop. 2006;26:164-170.
4. Al-Sayyad MJ. Taylor spatial frame in the treatment of neglected fractures. J ChildOrthop. 2011;5:135-141.
5. Al-Sayyad MJ. Taylor spatial frame in the treatment of upper extremity conditions. JPediatr Orthop. 2012;32:169-178.
6. Blondel B, Launay F, Glard Y, Jacopin S, Jouve J, Bollini G. Limb lengthening anddeformity correction in children using hexapodal external fixation: preliminaryresults for 36 cases. Orthop Traumatol Surg Res. 2009;95:425-430.
7. Blondel B, Launay F, Glard Y, Jacopin S, Jouve JL, Bollini G. Hexapodal externalfixation in the management of children tibial fractures. J Pediatr Orthop B.2010;19:487-491.
8. Docquier PL, Rodriguez D, Mousny M. Three-dimensional correction of complexleg deformities using a software assisted external fixator. Acta Orthop Belg.2008;74:816-822.
9. Eidelman M, Bialik V, Katzman A. Correction of deformities in children using the Taylor Spatial Frame. J Pediatr Orthop B. 2006;15:387-395.
10. Eidelman M, Katzman A. Treatment of complex foot deformities in children with the taylor spatial frame. Orthopedics. 2008;31(10).
11. Eidelman M, Zaidman M, Katzman A. Treatment of posttraumatic deformities inchildren and adolescents using the Taylor Spatial Frame. Orthopedics. 2010;33:253-256.
12. Eidelman M, Katzman A, Zaidman M, Keren Y. Deformity correction usingsupramalleolar gigli saw osteotomy and Taylor spatial frame: how to perform thisosteotomy safely? J Pediatr Orthop B. 2011;20:318-322.
13. Eidelman M, Katzman A. Treatment of arthrogrypotic foot deformities with the TaylorSpatial Frame. J Pediatr Orthop. 2011;31:429-434.
14. Eidelman M, Keren Y, Katzman A. Correction of residual clubfoot deformities inolder children using the Taylor spatial butt frame and midfoot Gigli saw osteotomy. JPediatr Orthop. 2012;32:527-533.
15. Elbatrawy Y, Fayed M. Deformity correction with an external fixator: ease of use andaccuracy? Orthopedics. 2009;32:82.
16. Fadel M, Hosny G. The Taylor spatial frame for deformity correction in the lowerlimbs. Int Orthop. 2005;29:125-129.
17. Feldman DS, Madan SS, Koval KJ, van Bosse HJ, Bazzi J, Lehman WB. Correctionof tibia vara with six-axis deformity analysis and the Taylor Spatial Frame. J PediatrOrthop. 2003;23:387-391.
18. Feldman DS, Shin SS, Madan S, Koval KJ. Correction of tibial malunion andnonunion with six-axis analysis deformity correction using the Taylor Spatial Frame. JOrthop Trauma. 2003;17:549-554.
19. Feldman DS, Madan SS, Ruchelsman DE, Sala DA, Lehman WB. Accuracy ofcorrection of tibia vara: acute versus gradual correction. J Pediatr Orthop.2006;26:794-798.
20. Floerkemeier T, Stukenborg-Colsman C, Windhagen H, Waizy H. Correction ofsevere foot deformities using the Taylor spatial frame. Foot Ankle Int. 2011;32:176-182.
21. Harbacheuski R, Fragomen AT, Rozbruch SR. Does lengthening and then plating(LAP) shorten duration of external fixation? Clin Orthop Relat Res. 2012;470:1771-1781.
22. Hassan A, Letts M. The management of the neglected congenital foot deformity inthe older child with the Taylor spatial frame. J Pediatr Orthop. 2012;32:85-92.
23. Henderson DJ, Barron E, Hadland Y, Sharma HK. Functional outcomes after tibialshaft fractures treated using the Taylor spatial frame. J Orthop Trauma. 2015;29:e54-59.
24. Iobst C. Limb lengthening combined with deformity correction in children with theTaylor Spatial Frame. J Pediatr Orthop B. 2010;19:529-534.
25. Khunda A, Al-Maiyah M, Eardley WGP. The management of tibial fracture nonunionusing the Taylor Spatial Frame. J Orthop. 2016;13:360-363.
26. Kristiansen LP, Steen H, Reikeras O. No difference in tibial lengthening index byuse of Taylor Spatial Frame or Ilizarov external fixator. Acta Orthop. 2006;77:772-777.
27. Lahoti O, Findlay I, Shetty S, Abhishetty N. Intentional deformation and closure ofsoft tissue defect in open tibial fractures with a taylor spatial frame--a simpletechnique. J Orthop Trauma. 2013;27:451-456.
28. Li Y, Spencer SA, Hedequist D. Proximal tibial osteotomy and Taylor Spatial Frameapplication for correction of tibia vara in morbidly obese adolescents. J PediatrOrthop. 2013;33:276-281.
29. Marangoz S, Feldman DS, Sala DA, Hyman JE, Vitale MG. Femoral deformitycorrection in children and young adults using Taylor Spatial Frame. Clin Orthop RelatRes. 2008;466:3018-3024.
30. Menakaya C, Rigby A, Hadland Y, Barron E, Sharma H. Fracture healing followinghigh energy tibial trauma: Ilizarov versus Taylor Spatial Frame. Ann R Coll Surg Engl.2014;96:106-110.
31. Nakase T, Kitano M, Kawai H, et al. Distraction osteogenesis for correction ofthree-dimensional deformities with shortening of lower limbs by Taylor SpatialFrame. Arch Orthop Trauma Surg. 2009;129:1197-1201.
32. Naqui SZ, Thiryayi W, Foster A, Tselentakis G, Evans M, Day JB. Correction ofsimple and complex pediatric deformities using the Taylor-Spatial Frame. J PediatrOrthop. 2008;28:640-647.
33. Robinson PM, Papanna MC, Somanchi BV, Khan SA. High tibial osteotomy inmedial compartment osteoarthritis and varus deformity using the Taylor spatialframe: early results. Strategies Trauma Limb Reconstr. 2011;6:137-145.
34. Rozbruch SR, Segal K, Ilizarov S, Fragomen AT, Ilizarov G. Does the Taylor SpatialFrame Accurately Correct Tibial Deformities? Clin Orthop Relat Res. 2010;468:1352-1361.
35. Sachs O, Katzman A, Abu-Johar E, Eidelman M. Treatment of Adolescent BlountDisease Using Taylor Spatial Frame With and Without Fibular Osteotomy: Is There anyDifference? J Pediatr Orthop. 2015;35:501-506.
36. Sala F, Thabet AM, Castelli F, et al. Bone transport for postinfectious segmentaltibial bone defects with a combined ilizarov/taylor spatial frame technique. J OrthopTrauma. 2011;25:162-168.
37. Sala F, Elbatrawy Y, Thabet AM, Zayed M, Capitani D. Taylor spatial frame fixationin patients with multiple traumatic injuries: study of 57 long-bone fractures. J OrthopTrauma. 2013;27:442-450.
38. Sluga M, Pfeiffer M, Kotz R, Nehrer S. Lower limb deformities in children: two-stagecorrection using the Taylor spatial frame. J Pediatr Orthop B. 2003;12:123-128.
39. Sokucu S, Karakoyun O, Arikan Y, Kucukkaya M, Kabukcuoglu Y. Efficacy of theTaylor spatial frame in the treatment of deformities around the knee. Acta OrthopTraumatol Turc. 2013;47:86-90.
40. Tafazal S, Madan SS, Ali F, et al. Management of paediatric tibial fractures usingtwo types of circular external fixator: Taylor spatial frame and Ilizarov circular fixator.J Child Orthop. 2014;8:273-279.
41. Thiryayi WA, Naqui Z, Khan SA. Use of the Taylor Spatial Frame in CompressionArthrodesis of the Ankle: A Study of 10 Cases. J Foot Ankle Surg. 2010;49:182-187.
42. Tsibidakis H, Kanellopoulos AD, Sakellariou VI, Soultanis K, Zoubos AB,Soucacos PN. The role of Taylor Spatial Frame for the treatment of acquired andcongenital tibial deformities in children. Acta Orthop Belg. 2014;80:419-425.
43. Viskontas DG, MacLeod MD, Sanders DW. High tibial osteotomy with use of theTaylor Spatial Frame external fixator for osteoarthritis of the knee. Can J Surg.2006;49:245-250.
44. Zenios M. The use of the taylor spatial frame for the treatment of unstable tibialfractures in children. J Orthop Trauma. 2013;27:563-568.
45. Donnan LT, Saleh M, Rigby AS. Acute correction of lower limb deformity andsimultaneous lengthening with a monolateral fixator. J Bone Joint Surg Br.2003;85:254-60