3066 consecutive Gamma Nails. 12 years experience at a single centreReport as inadecuate




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BMC Musculoskeletal Disorders

, 11:133

First Online: 26 June 2010Received: 17 October 2009Accepted: 26 June 2010

Abstract

BackgroundFixation of trochanteric hip fractures using the Gamma Nail has been performed since 1988 and is today well established and wide-spread. However, a number of reports have raised serious concerns about the implant-s complication rate. The main focus has been the increased risk of a subsequent femoral shaft fracture and some authors have argued against its use despite other obvious advantages, when this implant is employed.

Through access to a uniquely large patient data base available, which is available for analysis of trochanteric fractures; we have been able to evaluate the performance of the Gamma Nail over a twelve year period.

Methods3066 consecutive patients were treated for trochanteric fractures using Gamma Nails between 1990 and 2002 at the Centre de Traumatologie et de l-Orthopedie CTO, Strasbourg, France. These patients were retrospectively analysed. Information on epidemiological data, intra- and postoperative complications and patients- outcome was retrieved from patient notes. All available radiographs were assessed by a single reviewer AJB.

ResultsThe results showed a low complication rate with the use of the Gamma Nail. There were 137 4.5% intraoperative fracture-related complications. Moreover 189 6.2% complications were detected postoperatively and during follow-up. Cut-out of the lag screw from the femoral head was the most frequent mechanical complication 57 patients, 1.85%, whereas a postoperative femoral shaft fracture occurred in 19 patients 0.6%. Other complications, such as infection, delayed healing-non-union, avascular femoral head necrosis and distal locking problems occurred in 113 patients 3.7%.

ConclusionsThe use of the Gamma Nail in trochanteric hip fractures is a safe method with a low complication rate. In particular, a low rate of femoral shaft fractures was reported. The low complication rate reported in this series can probably be explained by strict adherence to a proper surgical technique.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-11-133 contains supplementary material, which is available to authorized users.

Alicja J Bojan, Claudia Beimel contributed equally to this work.

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Author: Alicja J Bojan - Claudia Beimel - Andreas Speitling - Gilbert Taglang - Carl Ekholm - Anders Jönsson

Source: https://link.springer.com/







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