[Comparative study of the treatment of pertrochanteric fractures--trochanteric gamma nail vs. proximal femoral nail].
OBJECTIVE
We have performed a retrospective comparative study between the trochanteric gamma nail (TGN) and the proximal femoral nail (PFN).


METHODS
During the period 1998-2003, 97 TGN and 83 PFN were used for the treatment of pertrochanteric fractures. Most of the fractures were of the A3 type according to the AO/ASIF classification. Clinical and radiological follow-ups were available for 87 TGN and 65 PFN.


RESULTS
The mean operative time for the TGN was shorter than that for the PFN. Intraoperative complications were noted in 17.5 % and 28.8 % for the TGN and PFN groups, respectively. Late complications occurred in 18.4 % for TGN compared to 27.6 % of the PFN. Union was achieved in 94.2 % and 89.3 % of the patients treated with the TGN and PFN, respectively. The reoperation rates were 10.3 % and 24.6 % for the TGN and the PFN, respectively. Clinical outcomes were good for both groups (65 % in the TGN, 62 % in the PFN group).


CONCLUSIONS
Treatment of pertrochanteric fractures using the TGN and PFN implants is quite reliable. The major complication was cut-out and occurred mostly in the PFN group, while varus deformity was more frequent in the TGN group. The PFN was associated with a higher rate of reoperation and longer operative time, probably due to a more demanding technique.
Megas
P
P
Orthopädische Klinik, Universitätsklinikum Patras, Griechenland.
Kaisidis
A
A
Zouboulis
P
P
Papas
M
M
Panagopoulos
A
A
Lambiris
E
E
D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails / Q000706:statistics & numerical data*; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011859:Radiography; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome