title: Gamma nails and dynamic hip screws for peritrochanteric fractures. A randomised prospective study in elderly patients.
abstract: The Gamma nail was introduced for the treatment of peritrochanteric fractures with the theoretical advantage of a load-sharing femoral component which could be implanted by a closed procedure. We report a randomised prospective study of 186 fractures treated by either the Gamma nail or a dynamic hip screw. Gamma nails were implanted with significantly shorter screening times, smaller incisions, and less intraoperative bleeding. The Gamma nail group had a shorter convalescence and earlier full weight-bearing, but there was no significant difference in mortality within six months, postoperative mobility, or hip function at review. More intra-operative complications were recorded in the Gamma nail group, mainly due to the mismatching of the femoral component of the nail to the small femurs of Chinese people. Use of a smaller modified nail reduced these complications. We conclude that with careful surgical technique and the modified femoral component, the Gamma nail is an advance in the treatment of peritrochanteric fractures.
authors.affiliation: Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
authors.forename: K S
authors.initials: KS
authors.lastname: Leung
authors.forename: W S
authors.initials: WS
authors.lastname: So
authors.forename: W Y
authors.initials: WY
authors.lastname: Shen
authors.forename: P W
authors.initials: PW
authors.lastname: Hui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001863:Bone Screws; D003627:Data Interpretation, Statistical; D005260:Female; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography