title: Proximal femoral nail antirotation and third-generation Gamma nail: which is a better device for the treatment of intertrochanteric fractures?
abstract: BACKGROUND
  Proximal femoral nail antirotation (PFNA) and third-generation Gamma nail (Gamma 3) are widely used in the treatment of intertrochanteric fractures. However, it remains unclear which device achieves better clinical and radiographic outcomes when treating intertrochanteric fractures.
  
  
  METHODS
  This study comprised 239 patients with intertrochanteric fractures treated with either PFNA or Gamma 3 for a minimum of 12 months. During surgery, the operative time, image intensifier time and amount of blood loss were recorded. Following surgery, we assessed reduction quality and implant position. At the final follow-up, postoperative complications, including femoral shaft fracture, cutout, reoperation, pneumonia, urinary tract infection, cerebral infarction, cardiac infarction and decubital ulcer, were recorded. In addition, walking ability was assessed using the Parker-Palmer mobility score.
  
  
  RESULTS
  No difference was found in the operative time, image intensifier time and amount of blood loss between patients treated with PFNA and those treated with Gamma 3. The reduction quality of fractures treated with Gamma 3 was better than those treated with PFNA. However, there were no significant differences in implant position, walking ability and postoperative complications between the two groups. Although Gamma 3 resulted in better reduction quality, it did not provide any advantages in walking ability and postoperative complications when compared with PFNA.
  
  
  CONCLUSIONS
  Therefore, we conclude that both PFNA and Gamma 3 are safe and reliable devices for the treatment of intertrochanteric fractures.
authors.affiliation: Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, China.
authors.forename: Yue-Hua
authors.initials: YH
authors.lastname: Yang
authors.forename: Yu-Ren
authors.initials: YR
authors.lastname: Wang
authors.forename: Sheng-Dan
authors.initials: SD
authors.lastname: Jiang
authors.forename: Lei-Sheng
authors.initials: LS
authors.lastname: Jiang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D020127:Recovery of Function; D012399:Rotation