Outcome after treatment of complications of Gamma nailing: a prospective study of 554 trochanteric fractures.
BACKGROUND
A high reoperation rate has been the main reason why Gamma nailing should not be recommended for routine use in the treatment of trochanteric fractures. We compared the outcome after reoperation to the outcome after primary surgery with Gamma nailing.


METHODS
In a series of 554 patients, we compared the outcome in 52 patients who were reoperated with that in 502 patients who had no reoperations. We assessed mortality, pain, walking ability and habitat at follow-up.


RESULTS
The most common reason for reoperation was new fracture around the implant (17), local pain after healed fracture (11), nonunion (9) and cut-out (8). A second reoperation was required in 9/52 patients. The mortality was significantly lower in the reoperated cases at 30 days and at 1-5 years, but not at 120 days, and there were no significant differences in the other outcome parameters.


CONCLUSIONS
Reoperation did not lead to a worse clinical outcome, nor to increased mortality.
Bjørgul
Kristian
K
Department of Orthopaedics, Østfold Hospital, Oslo, Norway. Kristianb@halden.net
Reikerås
Olav
O
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails / Q000009:adverse effects*; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome