Implant failure of long Gamma nail in a patient with intertrochanteric-subtrochanteric fracture

Yoshino, Nobuyuki; Watanabe, Yoshinobu; Takenaka, Nobuyuki; Watanabe, Nobuyoshi; Fukuda, Yukihisa; Fujita, Norifumi; Maruyama, Norio; Sumiyoshi, Hideshi; Takai, Shinro

doi:10.1007/s00776-006-1068-z

Cited by 15 publications

(7 citation statements)

References 19 publications

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“…Therefore, there is no cephalomedullary nail reported in the literature not presenting the complication of nail breakage [ 13 – 16 ]. By experience [ 8 ] and literature [ 1 – 27 ], we know that the hole for the lag screw seems to be the weakest point, as it has a relatively small cross-sectional diameter [ 28 ]. This is the critical zone where forces from the femoral neck are transmitted to the nail in the femoral shaft [ 20 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Breakage in Two Points of a Short and Undersized “Affixus” Cephalomedullary Nail in a Very Active Elderly Female: A Case Report and Review of the Literature

Rollo

Rinonapoli

Pichierri

et al. 2018

Case Reports in Orthopedics

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Introduction Trochanteric fractures of the femur are common in elderly individuals with osteoporosis. The use of cephalomedullary nails is increasing, and they are now the most commonly used fixation devices, especially for the treatment of unstable trochanteric fractures. The nail breakage is not the most common complication of intramedullary nailing. Many scientific papers report nail breakage in a specific location: through the lag screw hole, the nail shaft, or the distal locking hole. Materials and Methods We present a case of an 84-year-old patient treated with modular revision hip arthroplasty due to the breakage in two points of a cephalomedullary nail implanted 3 years earlier for a subtrochanteric fracture. Results After modular revision hip arthroplasty, the functional results and quality of life have been excellent. Conclusions As far as we could determine, this appears to be the first case of a breakage of a cephalomedullary nail in two points after nonunion in a very active elderly female.

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Section: Discussionmentioning

confidence: 99%

Breakage in Two Points of a Short and Undersized “Affixus” Cephalomedullary Nail in a Very Active Elderly Female: A Case Report and Review of the Literature

Rollo

Rinonapoli

Pichierri

et al. 2018

Case Reports in Orthopedics

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“…Because of the material strength and mechanical advantage, implant failure of the Gamma nail is rare [23, 24]. We present a case of breakage of a third generation Gamma nail used to treat an unstable trochanteric fracture, which was thought to be mainly due to insufficient reduction of the fracture.…”

Section: Discussionmentioning

confidence: 99%

Breakage of a Third Generation Gamma Nail: A Case Report and Review of the Literature

Igarashi

Niikura

Lee

et al. 2013

Case Reports in Orthopedics

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The use of intramedullary nails to treat trochanteric fractures of the femur has increased with the increasing size of the elderly population. The third generation Gamma nail is currently one of the most popular devices for the treatment of trochanteric fractures. Nail breakage is a rare complication, possibly resulting from fatigue fracture of the implant. We present the first reported case of breakage of a third generation Gamma nail that was not used to treat a pathological fracture. An 83-year-old woman with an unstable trochanteric fracture of the femur was treated using a third generation Gamma nail. She was referred to our hospital 14 months postoperatively with nail breakage at the opening for the lag screw. The breakage was secondary to nonunion, which was thought to be mainly due to insufficient reduction of the fracture. The broken nail was removed, and the patient underwent cemented bipolar hemiarthroplasty. At followup 18 months later, she was mobile with a walker and asymptomatic with no complications. This case shows that inadequate operation such as insufficient reduction of the trochanteric fracture may result in nonunion and implant breakage, even when using a high-strength, well-designed implant.

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“…[22,40] However, the clinical application of Gamma Nails is associated with several complications, including breakage of the lag screw and fracture of the femora distal to the intramedullary device. [26,41–44] Another robust intramedullary nail system, INTERTAN, is a new-generation intramedullary fixation device manufactured by Smith & Nephew for fixation of proximal femoral fractures. The main features of INTERTAN are a preloaded cannulated set screw that facilitates sliding; a figure-8-shaped integrated interlocking lag and compression screws that offer superior inner compression and enhanced stability; and the trapezoidal surface of the proximal nail that enhances the rotational stability of the nail in the medullary cavity.…”

Section: Introductionmentioning

confidence: 99%

Comparison of internal fixation with Gamma3 Long nails and INTERTAN nails in the treatment of Seinsheimer type V subtrochanteric femoral fractures in elderly patients

Li¹,

Zhu²,

et al. 2019

Medicine

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The aim of this study was to clinically compare the therapeutic effects of internal fixation using a third-generation Gamma Long Nail (TGLN) with that of INTERTAN in the treatment of Seinsheimer Type V subtrochanteric femoral fractures in elderly patients. The therapeutic effect of internal fixation with TGLN, compared with that with INTERTAN, was retrospectively analyzed in elderly patients diagnosed with Seinsheimer Type V subtrochanteric fracture. Twenty-five cases were divided into 2 groups based on the fixation devices: the TGLN group (13 cases; 5 men and 8 women) and the INTERTAN group (12 cases; 5 men and 7 women). Patients were followed up postoperatively, and their clinical history, intraoperative blood loss, fracture healing, Harris Hip Scores, and postoperative complications were recorded and compared. Patients in the TGLN group had shorter operation time and less intraoperative blood loss, compared with those in the INTERTAN group ( P < .05). There were no significant between-group differences in postoperative complications, fracture healing time and Harris Hip Scores during the follow-up ( P > .05).

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Implant failure of long Gamma nail in a patient with intertrochanteric-subtrochanteric fracture

Cited by 15 publications

References 19 publications

Breakage in Two Points of a Short and Undersized “Affixus” Cephalomedullary Nail in a Very Active Elderly Female: A Case Report and Review of the Literature

Breakage in Two Points of a Short and Undersized “Affixus” Cephalomedullary Nail in a Very Active Elderly Female: A Case Report and Review of the Literature

Breakage of a Third Generation Gamma Nail: A Case Report and Review of the Literature

Comparison of internal fixation with Gamma3 Long nails and INTERTAN nails in the treatment of Seinsheimer type V subtrochanteric femoral fractures in elderly patients

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