J Korean Fract Soc.  2014 Jul;27(3):213-221. 10.12671/jkfs.2014.27.3.213.

Results of Asian Type Gamma 3 Nail in Treatment of Trochanteric Fractures

• Huang BZ
• Park YW
• Park JS
• Noh KC
• Kim SY
• Chung KJ
• Kim HK
• Kim HN
• Yoon YH
• Hwang JH

• KMID: 1708714
• DOI: http://doi.org/10.12671/jkfs.2014.27.3.213

Abstract

PURPOSE
This study was conducted in order to demonstrate the radiologic and clinical results of using the Asian type gamma 3 nail in treatment of trochanteric fractures.
MATERIALS AND METHODS
Patients underwent operations with gamma 3 nails between August 2010 and August 2012. For the radiologic evaluation, we analyzed bone quality, fracture pattern, reduction quality, union period, and position of lag screw (tip-apex distance, Cleveland index). For the clinical evaluation, we analyzed mobility score of Palmer and Parker and Jensen's functional score.
RESULTS
The mean union was taken at 17.4 weeks (14-25 weeks). Two cases (4.3%) underwent reoperation due to cutting out of the hip screws. The clinical outcomes of Parker and Palmer's average mobility score changed from 7.3 to 5.8 (79%), Jensen's functional score was 1.3 to 1.8 (72%).
CONCLUSION
We achieved excellent clinical and radiological outcomes; therefore, Asian type gamma 3 nail is effective in treatment of trochanteric fractures of the femur in Korea.

Keyword

Femur; Trochanteric fracture; Gamma nail

MeSH Terms

Asian Continental Ancestry Group*
Femur
Hip
Hip Fractures*
Humans
Korea
Reoperation

Figure

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  Fig. 1 Photograph of Asia Pacific and Japanese version's gamma 3 nail.

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  Fig. 2 The patient is an 84-year-old female. (A, B) Preoperative radiograph shows an unstable fracture, AO A22. (C, D) Immediate postoperative x-ray shows relatively good reduction, but a lag screw was eccentrically positioned.

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  Fig. 3 (A) Radiograph shows a typical cut out of the femoral head at three months after the operation. (B) Cross table lateral x-ray.

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  Fig. 4 A 67-year-old female's hip shows AO type 32. (A, B) Preoperative radiograph shows a reverse pattern trochanteric fracture. (C, D) Postoperative x-ray shows unsatisfied reduction of the fracture.

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  Fig. 5 (A, B) Lag screw was cut out of the femoral head three months after the operation. (C, D) We converted bipolar hemiarthroplasty after removal of the gamma nail.

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  Fig. 6 Photograph of the sureshot guide, which was assembled to the troca.

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  Fig. 7 (A) Use of the sureshot guide to help determine proper nail positioning was shown under fluoroscopy. (B) Cross table lateral view.

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