Treatment of complex subtrochanteric fracture with the long gamma AP locking nail: a prospective evaluation of 64 cases.
BACKGROUND
Complex subtrochanteric fractures are uncommon injuries and challenging to manage. We elucidate the role of the Long Gamma AP Locking Nail (LGAPN) in the management of such fractures in the acute stage.


METHODS
Between 1992 and 2002, 64 consecutive cases with nonpathologic complex subtrochanteric fractures managed with the LGAPN were enrolled in this study. Associated injuries were present in 16 cases. The average follow-up period was 68 months.


RESULTS
Mean time to union was 14 weeks. There were two complications (one wound infection and one delayed union). The time to union and functional results were not statistically different between different ages (below 50 years old, or older than 50 years) and the number of distal locking screws used (one or two). Longer time to union is noted in patients with a longer operation time and a more comminuted fracture pattern by the AO classification.


CONCLUSIONS
Closed reduction and internal fixation with the LGAPN were proven to be safe and effective in the treatment of complex traumatic subtrochanteric fractures in all age groups, and one distal locking screw is sufficient for distal fixation.
Cheng
Ming-Te
MT
Departments of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
Chiu
Fang-Yao
FY
Chuang
Tien-Yow
TY
Chen
Chuan-Mu
CM
Chen
Tain-Hsiung
TH
Lee
Pui-Ching
PC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails / Q000706:statistics & numerical data*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D013624:Taiwan / Q000453:epidemiology