J Korean Fract Soc.  2011 Jan;24(1):7-15. 10.12671/jkfs.2011.24.1.7.

Operative Treatment with Gamma 3 Nail in Femur Intertrochanteric Fracture

• Hong KD
• Sim JC
• Ha SS
• Kim TH
• Choi YH
• Kim JH

• KMID: 1449410
• DOI: http://doi.org/10.12671/jkfs.2011.24.1.7

Abstract

PURPOSE
To evaluate clinical and radiological results of surgical treatment of femur intertrochantenric fracture using Gamma 3 nail.
MATERIALS AND METHODS
With clinical study, 22 patients who were treated surgically by Gamma 3 nail were retrospectively evaluated. By postoperative radiograph and last follow up radiograph we measured Tip-apex distance, Cleveland index, Neck-shaft angle change Lag screw slippage and Union time. And By medical record review, the clinical results were evaluated with the operation time, intraperative estimated blood loss, amount of transfusion, change of mobility and complication.
RESULTS
The mean change of femur neck shaft angle was 5.18 degrees. The mean lag screw sliding was 5.43 mm. The mean bone union time was 11.8 weeks. From all of these examples shows bone union. The mean operative time was 41 min, blood loss was 161 ml and the transfusion amount was 0.3 pint. In Ceder et al mobility score, it showed 0.2 point decreased and in Jensen social function score, it showed 0.6 point increased. Comparing the results before and after operation, the results were satisfactory.
CONCLUSION
Using the Gamma 3 nail, the treatment of fermur intertrochanteric fractures showed good results both radiologically and clinically.

Keyword

Femur; Intertrochanteric fracture; Gamma 3 nail

MeSH Terms

Femur
Femur Neck
Follow-Up Studies
Hip Fractures
Humans
Medical Records
Nails
Operative Time
Retrospective Studies

Figure

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  Fig. 1 Gamma 3 nail use sure shot guide to help determine correct nail positioning to allow proper placement of the lag screw.

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  Fig. 2 (A) 80 year old male patient presented with intertrochanteric fracture as AO/ASIF classification A2.1. (B) Postoperative radiographs show acceptable reduction and well positioned lag screw. (C) Postoperative 6 months radiographs show minimal sliding of lag screw and well unite fracture site.

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  Fig. 3 (A) 75 year old female patient presented with intertrochanteric fracture as AO/ASIF classification A2.2. (B) Postoperative radiographs show a minor split at the cortex of femur shaft and fixed with Gamma 3 long nail and roll wires. (C) Postoperative 6 months radiographs show moderate sliding of lag screw and well united fracture site.

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  Fig. 4 (A) 86 year old female patient presented with intertrochanteric fracture as AO/ASIF classification A2.2. (B) Postoperative radiographs show distal tip of nail contacts with anterior femur cortex. (C) Postoperative 6 months radiographs show well united fracture site but the patient complains about thigh pain.

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  Fig. 5 Gamma 3 nail, curved flexible target device allow small incisions, preventing soft tissue pressure and collision with iliac crest.

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