[Surgical stabilization of per- and subtrochanteric femoral fractures with the gamma nail].

BACKGROUND

From 1992 through 1997 96 patients with per- or subtrochanteric femur fractures were treated with a Gamma nail. We retrospectively evaluated the influence of patient age, additional diseases, type of fracture, time of operation, type of implant (short/long Gamma nail) and surgical approach (open/closed reduction) on the mobility of the patients, healing of the fractures on radiographs, and possible complications.

PATIENTS AND

METHODS

The average patient age was 72.5 years (range 27 to 101). There were 27 male and 69 female patients. Surgery was performed 1.19 (0-10) days after injury. At 3, 6, and 12 months after surgery radiographs of the involved hip joint and femur were obtained and the degree of mobility was assessed.

RESULTS

Additional diseases, type of fracture, time of operation, type of implant (short/long Gamma nail) and surgical approach (open/closed reduction) did not influence mobility of the patients, healing of the fractures on radiographs or rate of complications. It was more difficult to mobilize older patients (P < 0.001). After 1 year 97% of all fractures had healed on radiographs. In 15 patients (18%) complications occurred due to technical errors using the Gamma nail.

DISCUSSION: With the Gamma nail stable osteosynthesis of per- and subtrochanteric femur fractures is obtained independently of the fracture classification. Patients can be mobilized immediately. Technical errors must be avoided.