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Abstract Objective To explore the clinical efficacy of expandable proximal femoral nail (EPFN) in the treatment of osteoporotic intertrochanteric fractures in elderly patients.Methods 49 elderly patients with osteoporotic intertrochanteric fractures admitted to our department from January 2015 to December 2016 were selected and randomly fixed with EPFN and InterTAN respectively.There were 23 patients in the EPFN treatment group，including 7 males and 16 females with an average age of (75.2±6.1) years (range：68~89).There were 16 cases of AO/OTA 31-A2 type and 7 cases of 31-A3 type.The InterTAN treatment group had 26 patients，including 10 males and 16 females with an average (73.2±2.6)years old(range：70~87).The operation time，intraoperative fluoroscopy time，intraoperative blood loss，surgical incision length，postoperative weight bearing time，fracture healing time，postoperative complication rate and Harris hip function score were evaluated and compared.Results Patients in both groups were followed up for 24 to 48 weeks，with an average of (36.0±6.7)weeks.There was 1 case of bedsores in the EPFN group，1 case of pulmonary infection，1 case of urinary tract infection after operation in the InterTAN group，1 case of contralateral femoral neck fracture.There was no significant difference in the postoperative complications between the two groups (P＞0.05).The operation time，intraoperative fluoroscopy time，intraoperative blood loss，and surgical incision length in the EPFN group were significantly shorter or less than those in the InterTAN group (P＜0.05).There was no significant differences of postoperative weight bearing time，fracture healing time and Harris hip function scores between the two groups (P＞0.05).Conclusion EPFN and InterTAN for the treatment of elderly osteoporotic intertrochanteric fractures have the advantages of less trauma，firm fixation，early mobility，and fewer complications.However，EPFN is simple to operate and is superior in terms of shortening operation time and reducing intraoperative blood loss.InterTAN is more suitable for elderly patients with poor physical tolerance
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