Abstract

• In old age, trochanteric fracture occurs easily by trivial external force due to osteoprosis and many kinds of treatment has been performed. The goal of treatment in elderly patients with trochanteric fractures is restoration of function to preoperative ambulatory status at the earliest possible time. For this purpose operative treatment is gernerally recommended. The success of operative treatment depends on the stable reduction and secure fixation.
  Gamma nail is a new intramedullary device which has been applied in the treatment of trochanteric fractures with the benefits of the closed technique such as low blood loss, low risk of infection and short operative time. The implant can be used by the method of static or dynamic. Intraoperative compression of the fracture segments can be achieved by acting on the sliding lag screw and further compression is given by weight bearing.
  We studied 22 cases of patient who had the trochanteric fracture and treated operatively with gamma-locking nail at the department of orthopaedic surgery, Dong-A university hospital from January 1993 to December 1994. Among 22 cases, 7 cases were stable fracture and 14 cases were unstable fracture by the Evans classification. Mean operation time was 76 minutes and mean blood loss was 303 mf and intraoperative and postoperative complicatins were encountered in 3 cases, femur shaft fracture in 2 casea and lag screw displacement on the femoral head in 1 case.
  Based on the above results, we have experienced limited utiliBation of the nail because of the mappropriateness between nail and femur itself and non-skillful application technique. We think that if nail shape and assembly for fixating distal screw are improved, Gamma-interlocking nail is a good interraf fixation device which allows early weight bearing ambulation.

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