Reverse oblique intertrochanteric femoral fractures treated with the gamma nail

Abstract

We studied 47 reverse oblique intertrochanteric femoral fractures that were treated with gamma nails between 1992 and 2000. Fracture reduction was satisfactory in 38 patients (81%), the hip screw position was correct in 42 (89%) and there were no peri-operative complications. However, in three patients the nail displaced, resulting in non-union in one and protrusion into the acetabulum in another. A logistical regression analysis of our series showed that an incorrect position of the hip screw in the femoral head was the only predictor for complications. Thus, we consider that the gamma nail is a good option for the treatment of these complex fractures.

Prospective randomised controlled trial of an intramedullary nail versus a sliding hip screw for intertrochanteric fractures of the femur

“…Anteroposterior and lateral X-rays were obtained at each follow-up visit. Fracture union was defined as the presence of visible bone trabeculae between bone fragments in both views, accompanied by pain-free walking [24]. Patients' postoperative state was evaluated at each follow-up visit and compared with preinjury status using the Parker score, Barthel Index and EQ-5D.…”

New classification focusing on the relationship between the attachment of the iliofemoral ligament and the course of the fracture line for intertrochanteric fractures

“…In addition, appropriate implants should be selected for fixation of the distal primary fragment, and postoperative stable reduction should be achieved. As clinical outcomes for the patients using SHS were poor, an intramedullary nail (IMN), such as SFN and long femoral nail (LFN), tended to be recommended [14][15][16][17][18][19]. However, it has not been clear whether LFN or SFN should be used in the different types of intertrochanteric fractures.…”

“…displacement. It should be noted that retention of the reduction during surgery is quite difficult and technically demanding [14][15][16]. In addition, appropriate implants should be selected for fixation of the distal primary fragment, and postoperative stable reduction should be achieved.…”

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“…Haidukewych et al (1), Rokito et al (2), and Henry et al (3) all believed that this device was not suitable for AO/OTA 31-A3 intertrochanteric femoral fractures. Treating these fractures with the intramedullary nail has an advantage with respect to mechanics and efficacy in clinical applications (4)(5)(6). However, it is not minimally invasive.…”