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Osteosynthesis and Trauma Care 2005; 13(1): 18-25
DOI: 10.1055/s-2005-836371
Original Article

© Georg Thieme Verlag Stuttgart · New York

Fractures of the Proximal Femur. The Gamma Nail versus Plate

P. de Lucas1 , B. Seral1 , Á. Beano1 , J. A. Almodóvar1 , I. Domínguez1 , J. Rodríguez1 , E. Moro1
  • 1AIOD - España
Further Information

Publication History

Publication Date:
24 March 2005 (online)

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Abstract

Historically the fractures of the proximal femur have been a challenge for the orthopaedic surgeon, because of the high number of hardware failures and the high mortality rate. The social and medical importance of these fractures is increasing and will be higher in the future because of the improved life expectancy and osteoporosis. The development of new material as well as the design of new devices have improved the results of treatment of this kind of fractures. Historically the plate was the treatment of choice for this kind of fractures, but the high incidence of hardware failures and non-unions led to the introduction of the Gamma nail which initiated a revolution in the concept of treatment of this kind of fractures. The main treatment target is to restore the functional capacity of the patient as soon as possible with the much higher mechanical guarantees of the device in order to obtain the fracture consolidation. A review of the medical literature has been done as well an evaluation of the two main concepts of treatment: plate versus endomedullary nail. Both techniques are not without risks, both have technical complications related to the technique. These complications can be resolved with an adequate learning curve. The experience of the surgeon is important to decrease these technical complications. Although it can lead to controversy about the treatment type for the stable fractures of the EPF, almost all the authors accept the endomedullary γ nail (Gamma nail) as the most adequate treatment of the unstable fractures of the proximal femur extremity.

Key words

Proximal femur - intertrochanteric, subtrochanteric fracture - Gamma nail - sliding hip screw - cut out

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Pablo de Lucas MD

Department of Cirugía Ortopedia y Traumatología · Hospital Ramón y Cajal · University of Alcala de Henares

Cta de Colmenar s/n

28035 Madrid

Spain

Phone: +34/6 07 64 46 30

Fax: +34/9 16 23 65 29

Email: pdelucas@ctv.es

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