Failure of the titanium trochanteric gamma nail in ununited metastatic fractures.

Metastatic lesions often occur in the trochanteric region of the femur with a risk for pathologic fractures, requiring aggressive surgical treatment. We present two cases of mechanical failure of the Titanium Gamma 3 Nail 180 used for treatment of impending pertrochanteric pathologic fractures. Metallurgic and low power optical examination findings are presented. Treatment with intramedullary nailing devices has proven its efficacy. However in cases of delayed union or non-union, a fatigue fracture due to dynamic overload should be expected sooner of later. If there is no evidence of healing within six months postoperatively a hardware exchange or another therapeutic option should be considered.