J Korean Fract Soc.  2004 Oct;17(4):295-300. 10.12671/jkfs.2004.17.4.295.

Nailing in the Patients with Intertrochanteric Fractures of the Femur: Comparision Gamma Nail and Proximal Femoral Nail

• Ko SB
• Cho MR
• Kim TH
• Chang IW

• KMID: 2015362
• DOI: http://doi.org/10.12671/jkfs.2004.17.4.295

Abstract

PURPOSE: To evaluate the clinical and radiologic results of the fracture fixation using the Proximal Femoral Nail (PFN) or Gamma nail in patient with the intertrochanteric fractures.
MATERIALS AND METHODS
From January 1999 to February 2002, we reviewed 63 patients of intertrochanteric fractures including 31 patients managed with Gamma nail and 32 patients with PFN. In variate analysis of age, the pattern and stability of fracture, bone density (Singh index), preoperative patient activity, there was no difference between two groups. We evaluated the operation time, blood loss, stable reduction rate and varus reduction rate as operation-related factors, and radiologically investigated union time, the frequency of delayed union and nonunion, failure of fixation, status of the fracture line and complications. Functional results were evaluated by the possibility of early ambulation, ambulation ability at last follow up, and the pre and postoperative difference of ambulatory ability.
RESULTS
Mean operation time was 103+/-40 minutes in Gamma nail group and 101+/-28 minutes in PFN group. It was not statistically significant (p=0.801). Even though intraoperative blood loss was less in PFN group, it was not significant (p=0.601). Postoperative stable reduction rate was 31% in Gamma nail group and 30% in PFN group (p=0.934), suggesting not significant. Postoperative varus reduction and impacted amount of the fracture line was not significant. Delayed union developed in one case of Gamma nail group and 2 cases of PFN group. Mean loss of ambulation ability was 1.28 grade in Gamma nail group and 0.86 grade in PFN group (p=0.383). Statistical analysis was performed with the use of Student T test and Chi-square test. Analyses resulting in a p value of <0.05 were considered to show significance.
CONCLUSION
Generally, the radiologic and clinical results of intertrochanteric fractures were comparable for the PFN group and Gamma nail group. Even though it was not statistically significant, PFN group had superior results in operation time and blood loss than Gamma nail group for the fixation of the patients with intertrochanteric fracture.

Keyword

Intertrochanteric fracture; Gamma nail; Proximal femoral nail

MeSH Terms

Early Ambulation
Femur*
Follow-Up Studies
Fracture Fixation
Fractures, Bone
Hip Fractures*
Humans
Walking