The Titanium Gamma Nail as Routine Treatment of Pertrochanteric Femoral Fractures

Abstract

A retrospective study was aimed at determining whether complications like cut-out and femoral shaft fracture, which are associated with the first-generation Gamma nail, could be diminished by using the improved, third-generation Gamma nail, the so-called titanium Gamma nail. The study described here consisted of 71 patients with pertrochanteric femur fracture that were treated operatively with the titanium Gamma nail in our clinic in 2001. The evaluation was carried out on the basis of patients' records, X-ray analyses and, in some cases, telephone interviews. Specific complications included one femoral-shaft fracture far below the nail and one mal-positioned femoral neck screw. No typical cut-out of the femoral neck screw occurred in any of the patients. The rates of complications not associated with the implant, e. g., wound infection, were comparable to those reported in the literature. Due to improvements of the implant, particularly of the femoral lag screw, and to improvements of the surgical instruments, the titanium Gamma nail is considered to be a safe implant for all fractures of the trochanteric region of the femur.

cut-out - lag screw - femoral shaft fracture - complications - implant failure - fixed-nail plate - sliding-screw plate

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