title: [Randomized prospective study on the influence distal block and Gamma 3 nail on the treatment of intertrochanteric fractures of femur].
abstract: OBJECTIVE
  The purpose of this study is to assess the need to lock the Gamma 3 nail (Stryker, Mahwah New Jersey USA) distally for intertrochanteric fractures of femur 31-A1 and 31-A2 of the AO.
  
  
  METHODS
  Details were recorded on a sample of 177 patients with intertrochanteric femoral fractures treated in our hospital by a standard Gamma nail between June 2011 and January 2013. A prospective study was conducted by randomizing patients by year of birth, even numbers with, or odd number without, distal locking, forming two groups of 90 and 87 fractures, respectively.
  
  
  RESULTS
  The patients treated with a distal locking nail had an increased incidence of medical complications, a lower incidence of biomechanical complications, and an increase in the fracture collapse compared with the control group, with statistical significance (p < 0.05). It is also observed in the group with distal locking increased transfusion requirement and a higher death rate, with statistically significant differences (p < 0.05), but this significance disappears when adjusting for other patient-related characteristics.
  
  
  CONCLUSIONS
  Based on the results found in this work, the use of distal locking screw in the Gamma 3 nails should be restricted to unstable trochanteric fractures after reduction where additional stability to the intramedullary nail is required, and may decrease the risk of complications from use.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia, España. Electronic address: lopezvega.marcos@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: López-Vega
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia, España.
authors.forename: E R
authors.initials: ER
authors.lastname: Gil-Monzó
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia, España; Universidad de Valencia, Valencia, España.
authors.forename: J L
authors.initials: JL
authors.lastname: Rodrigo-Pérez
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital de Manises, Manises, Valencia, España.
authors.forename: J
authors.initials: J
authors.lastname: López-Valenciano
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia, España.
authors.forename: R H
authors.initials: RH
authors.lastname: Salanova-Paris
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia, España.
authors.forename: J
authors.initials: J
authors.lastname: Peralta-Nieto
authors.affiliation: Cátedra de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España.
authors.forename: M M
authors.initials: MM
authors.lastname: Morales-Suárez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Bloqueo; Clavo Gamma; Cut-out; Fractura; Fracture; Gamma nail; Intertrochanteric; Locking; Pertrocantérea