Advances in internal fixation methods for intertrochanteric femoral fractures: A narrative review

Abstract

Intertrochanteric femoral fractures are common in older adults. Internal fixation remains a mainstay of treatment, as appropriately selected fixation can restore mechanical stability and facilitate early mobilization. This narrative review focuses on commonly used fixation methods for intertrochanteric femoral fractures, including intramedullary devices such as PFNA and InterTan, extramedullary devices such as DHS and LCP, and emerging technology-assisted approaches such as PFBN, 3D-printed navigation templates, and robot-assisted fixation. The review summarizes the technical principles, clinical indications, potential advantages, and limitations of these methods, and discusses current trends toward minimally invasive, precise, and individualized fixation, as well as the potential role of new materials and technology-assisted procedures. The purpose of this review was to provide a clinically oriented reference for selecting appropriate internal fixation strategies according to fracture characteristics, bone quality, patient condition, and the available level of evidence, thereby supporting evidence-informed decision-making in the management of intertrochanteric femoral fractures.