title: The Long Gamma Nail for stabilisation of existing and impending pathological fractures of the femur: an analysis of 48 cases.
abstract: The results in a series of 42 patients with 48 impending or complete pathological femur fractures stabilised with the Long Gamma nail (Howmedica-Osteonics, Rutherford, NJ,USA) are presented. Twenty two impending and 26 completed pathological femoral fractures treated between 1995 and 1999 were retrospectively analysed. The mean age of the patients was 65.7 yrs (range: 40 to 88). All patients were treated with an 11-mm diameter Long Gamma Nail, inserted through a 5-cm incision proximal to the greater trochanter using the antegrade reaming technique. The mean surgical time was 98 minutes (range: 65 to 225). Reliable stability was achieved in all cases and pain relief was excellent. Complications included 2 superficial and 1 deep wound infections, 4 chest infections, 2 urinary tract infections, and 2 deaths in the recovery. Implant failure occurred in one patient and needed revision to a long stemmed total hip prosthesis. The Long Gamma nail offers the advantage of a technically less demanding percutaneous insertion through the tip of the greater trochanter, secure proximal femoral fixation and the ability to allow immediate or early weight-bearing ambulation. Because of these advantages, we recommend the use of the Long Gamma nail for stabilisation of pathologic and impending pathologic fractures of the femur.
authors.affiliation: Western Infirmary, Glasgow, UK. kmoholkar@hotmail.com
authors.forename: Kirti
authors.initials: K
authors.lastname: Moholkar
authors.forename: Ram
authors.initials: R
authors.lastname: Mohan
authors.forename: Peter
authors.initials: P
authors.lastname: Grigoris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D015331:Cohort Studies; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome