title: Treatment of unstable intertrochanteric femoral fractures with locking gamma nail (LGN): A retrospective cohort study.
abstract: BACKGROUND
  Intertrochanteric femoral fractures remain a challenge to orthopedists. Although technologies and instruments have been continuously improved, fixation failure still poses a problem in the treatment of unstable intertrochanteric femoral fractures. The objective of the present study was to evaluate the clinical efficacy of a new type of intramedullary fixing device--locking gamma nail (LGN)--in treating unstable intertrochanteric femoral fractures.
  
  
  METHODS
  From March 2009 to March 2012, 88 patients with unstable intertrochanteric femoral fractures were treated at our department with LGNs. Twelve patients were excluded from the study. The clinical and radiographic results of the remaining 76 patients were retrospectively analyzed.
  
  
  RESULTS
  The mean duration of operation, volume of blood loss, and hospital stay was 50 min, 85 mL, and 8.5 days, respectively. No perioperative complications. Seven patients died 1 year after surgery. The other 69 patients received a mean 23-month follow-up. The mean fracture healing time was 16 weeks. Nine patients felt pain in their hips. Ten patients experienced delayed fracture healing. No other complications. Sixty-one patients had recovered to preoperative levels of function, with a mean Harris hip score of 86.6 and a mean Parker-Palmer mobility score of 7.42. Patients with malreduction were more likely to sustain pain complications (p = 0.002). Older patients were more likely to experience delayed fracture healing (p = 0.045).
  
  
  CONCLUSIONS
  LGN is a simple and safe treatment for unstable intertrochanteric femoral fractures with satisfactory clinical efficacy and may be considered a new, minimally invasive operative method for treating unstable intertrochanteric femoral fractures.
authors.affiliation: Department of Orthopaedics, The 118th PLA Hospital, Wenzhou, Zhejiang, 325000, China. Electronic address: zhanglei_1121@126.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Orthopaedics, The 118th PLA Hospital, Wenzhou, Zhejiang, 325000, China.
authors.forename: Sixu
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, The 118th PLA Hospital, Wenzhou, Zhejiang, 325000, China.
authors.forename: Zhendong
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Orthopaedics, The 118th PLA Hospital, Wenzhou, Zhejiang, 325000, China.
authors.forename: Zaiyu
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Stomatology, The 118th PLA Hospital, Wenzhou, Zhejiang, 325000, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: He
authors.affiliation: Department of Orthopaedics, The 118th PLA Hospital, Wenzhou, Zhejiang, 325000, China.
authors.forename: Zhihao
authors.initials: Z
authors.lastname: Ying
authors.affiliation: Department of Orthopaedics, The 118th PLA Hospital, Wenzhou, Zhejiang, 325000, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Orthopaedics, Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou, Wenzhou, Zhejiang, 325000, China. Electronic address: wyhpi008@163.com.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D015331:Cohort Studies; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies
keywords: Intertrochanteric femoral fractures; Locking gamma nail; Unstable