Abstract：Objective To analyze the effects of different medial cortical support reduction on the results of radiological and clinical function in pertrochanteric fractures treated with InterTan fixation.Methods A total of 133 cases，including 61 men and 72 women，with average age (77.2±6.4)years of pertrochanteric fractures at Yanqing Hospital of Peking University Third Hospital were treated with InterTan from January 2017 to December 2020.They were divided into three groups according to the relationship of the medial cortex between the femoral shaft and the medial femoral neck after operation，positive support (group A，30 cases)，neutral support (group B，77 cases) and negative support (group C，26 cases).The patient demographic of the three groups were compared.The variations of neck-shaft angle and femoral neck length and functional scores after operation were also compared statistically.Results 133 patients were followed up for 3 to 24 months，with a mean follow-up of (12.1±8.9) months.In group C，two patients occurred cut-out，and underwent total hip arthroplasty revision.The rest of the patients had bony healing of the intertrochanteric fracture.At the final follow-up，the loss of neck stem angle was (2.10±1.61) °，(1.73±2.02) °，(5.60±5.61) ° in groups A、B and C，respectively.And the loss of femoral neck length was (2.16±1.30) mm，(1.92±1.16) mm，(5.62±4.22) mm respectively.Group C showed the greatest loss of cervical stem angle and femoral neck length，with statistically significant differences compared with groups A and B (P＜0.05).After 1 months of follow-up，the functional recovery scores in group A and group B showed good functional outcomes than group C(P＜0.05)，while the basic activities of daily living were all recovered after at the final follow-up.There was no statistical difference among the three groups (P＞0.05).Conclusion Positive and neutral support reduction of medial cortex combined with InterTan fixation resulted in the least loss of neck stem angle and femoral neck length in patients and can achieve better clinical results early in the postoperative period.In our clinical practice，we should avoid negative medial cortical support reduction to reduce the incidence of complications such as screw cut-out.
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