Jae-Cheon Sim; Tae-Ho Kim; Ki-Do Hong; Sung-Sik Ha; Jong-Seong Lee

doi:10.12671/jkfs.2013.26.1.37

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Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail: Jae-Cheon Sim, M.D., Tae-Ho Kim, M.D., Ki-Do Hong, M.D., Sung-Sik Ha, M.D., Jong-Seong Lee, M.D.; Journal of the Korean Fracture Society 2013;26(1):37-43.
DOI: https://doi.org/10.12671/jkfs.2013.26.1.37
Published online: January 17, 2013

Department of Orthopaedic Surgery, Sahmyook Medical Center, Seoul, Korea.

Address reprint requests to: Tae-Ho Kim, M.D. Department of Orthopaedic Surgery, Sahmyook Medical Center, 82, Mangu-ro, Dongdaemun-gu, Seoul 130-711, Korea. Tel: 82-2-2210-3320, Fax: 82-2-2212-2673, likeapple111@naver.com

• Received: August 2, 2012 • Revised: October 2, 2012 • Accepted: November 11, 2012

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Abstract
REFERENCES

Abstract

Purpose
To compare the result between the third generation gamma nail (gamma 3 nail) and proximal femoral nail anti-rotation (PFNA) in the treatment of unstable intertrochanteric fractures.
Materials and Methods
Between March 2009 and June 2011, 47 consecutive patients with unstable intertrochanteric femoral fractures were treated with gamma 3 nail or PFNA. We reviewed 24 cases of gamma 3 nail and 23 cases of PFNA. Retrospectively, we evaluated the mean operation time, amount of bleeding, average union period, reduction status, change of neck shaft angle, Tip-apex distance, Cleveland index, sliding of lag screw and complication on set of telephone interview and outpatient. We also evaluated the postoperative capability of function and mobility, using 'Modified Koval index'.
Results
There were no significant differences between the groups, which were treated with gamma 3 nail and PFNA. In addition, they did not show statistical difference. We experienced 2 cases of complication (gamma 3 nail 1 case, PFNA 1 case), which were cut-out of the femoral head.
Conclusion
The gamma 3 nail and PFNA were seen with good results in the treatment of unstable intertrochanteric fracture.
Key words: Femur intertrochanteric fracture, Gamma 3 nail, Proximal femoral nail anti-rotation

REFERENCES

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Fig. 1

Gamma 3 nail using sure shot guide of gamma 3 nail help determine correct nail positioning to allow proper placement of the lag screw.

Fig. 2

(A) A 85-year-old female patient presented with intertrochanteric fracture as AO/ASIF classification A2.3.

(B) Postoperative radiograph which is fixed with gamma 3 nail.

(C) Lateral view of postoperative radiograph.

(D) Postoperative 2 weeks radiograph shows cutting out of the lag screw.

(E) Postoperative 12 weeks radiographs show a aggravation of cut-out complication (Patient refused a re-operation.).

Fig. 3

(A) A 59-year-old female patient presented with intertrochanteric fracture as AO/ASIF classification A2.2.

(B) Postoperative radiograph which is fixed with proximal femoral nail anti-rotation (PFNA).

(C) Lateral view of postoperative radiograph.

(D) Postoperative 6 months radiograph shows cutting out of the PFNA blade.

(E) Reoperation was done with cemented bipolar hemiarthroplasty.

Table 1

Demographic Characteristics between the Group 1 and 2

M: Male, F: Female, BMD: Bone mineral density.

Table 2

Immediately Postoperative Reduction Status

Table 3

Comparison of Radiographic Results

Table 4

Comparison of Dlinical Results

preop: Preoperative, postop: Postoperative.

Figure & Data

REFERENCES

Citations

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Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail

J Korean Fract Soc. 2013;26(1):37-43. Published online January 31, 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.1.37

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Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail

Fig. 1 Gamma 3 nail using sure shot guide of gamma 3 nail help determine correct nail positioning to allow proper placement of the lag screw.

Fig. 2 (A) A 85-year-old female patient presented with intertrochanteric fracture as AO/ASIF classification A2.3. (B) Postoperative radiograph which is fixed with gamma 3 nail. (C) Lateral view of postoperative radiograph. (D) Postoperative 2 weeks radiograph shows cutting out of the lag screw. (E) Postoperative 12 weeks radiographs show a aggravation of cut-out complication (Patient refused a re-operation.).

Fig. 3 (A) A 59-year-old female patient presented with intertrochanteric fracture as AO/ASIF classification A2.2. (B) Postoperative radiograph which is fixed with proximal femoral nail anti-rotation (PFNA). (C) Lateral view of postoperative radiograph. (D) Postoperative 6 months radiograph shows cutting out of the PFNA blade. (E) Reoperation was done with cemented bipolar hemiarthroplasty.

Fig. 1

Fig. 2

Fig. 3

Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail

Table 1

Demographic Characteristics between the Group 1 and 2

M: Male, F: Female, BMD: Bone mineral density.

Table 2

Immediately Postoperative Reduction Status

Table 3

Comparison of Radiographic Results

Table 4

Comparison of Dlinical Results

preop: Preoperative, postop: Postoperative.

Table 1 Demographic Characteristics between the Group 1 and 2

M: Male, F: Female, BMD: Bone mineral density.

Table 2 Immediately Postoperative Reduction Status

Table 3 Comparison of Radiographic Results

Table 4 Comparison of Dlinical Results

preop: Preoperative, postop: Postoperative.