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Year : 2013  |  Volume : 48  |  Issue : 4  |  Page : 354-362

Clinical outcome of using a third-generation short gamma nail in the treatment of extracapsular proximal femoral fractures

Department of Orthopedic, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Ihab I El-Dessokey
Department of Orthopedics, Faculty of Medicine, Cairo University, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-1148.130489

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Introduction A sliding hip screw is still considered the gold-standard method for fixation of extracapsular hip fractures; however, failures are still encountered with some subtypes. A short gamma nail is considered to allow better fixation for unstable subtypes, with the additional advantages of intramedullary fixation. Aim The aim of the study was to prospectively evaluate the clinical outcome of traumatic proximal femoral fractures fixed with a short gamma nail (third-generation design), with a particular focus on our experience of surgical techniques. Patients and methods We prospectively reviewed the results of 20 patients who had undergone intramedullary fixation with a short gamma nail for traumatic extracapsular proximal femoral fractures in Kasr Al-Ainy hospitals during an 18-month period from September 2009 to March 2011. The average age of the patients was 55 years (range 31-69 years), with seven male patients and 13 female patients. The average operative time was 75 min (range 50-110 min). Clinical and radiographic assessments were performed during follow-up visits at 6 weeks, 12 weeks, 6 months, 1 year, and 1΍ years using the Kyle scoring system. Results Nineteen of the 20 traumatic fractures healed uneventfully. One patient required reoperation after a period of 6 months for screw cutout, although this patient was healed completely. Walking and squatting ability was restored in all patients by 6 months postoperatively. Conclusion This study suggests that a short gamma nail is a reliable implant for proximal femoral fractures, leading to a high rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and biomechanical advantages, but the operation is technically demanding, with some restrictions.

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