The results of a multicenter Italian study on the use of the Gamma nail for the treatment of pertrochanteric and subtrochanteric fractures: a review of 1181 cases.
A total of 1147 pertrochanteric and subtrochanteric fractures, 10 delays in consolidation and non-union, 24 pathologic fractures and osteolysis with the risk of fracture, treated with a gamma nail in 17 Italian departments of traumatology, were collected. In 70% of the patients weight-bearing was allowed during the first week postsurgery; 77% of the patients followed-up recovered the same ability to walk that had preceded trauma. Complications included intraoperative (1.8%) and postoperative (1.1%) diaphyseal fractures, cephalic screw cut out (2.2%), and breakage of the nail (0.4%). There were two cases of infection (0.3%). Most of the complications were related to errors in technique. The safest procedure is constituted by the choice of a nail with a thinner caliber, 2 mm diaphyseal over-reaming, insertion of the nail without the use of a hammer, and distal locking; the cephalic screw must always be inserted in the lower portion of the femoral head.
1a. Clinica Ortopedica, Ist. Rizzoli, Bologna.
S
S
Boriani
F
F
De Iure
G
G
Bettelli
L
L
Specchia
P
P
Bungaro
G
G
Montanari
A
A
Capelli
P
P
Canella
R
R
Regnoli
C
C
Triscari
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000706:statistics & numerical data; D005598:Fractures, Spontaneous / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D005599:Fractures, Ununited / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006620:Hip Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D013997:Time Factors