ABSTRACT
PURPOSE: To compare outcomes (i.e., clinical and radiological findings, postoperative complication) in the fixation of intertrochanteric fractures with U-blade Gamma3 and Gamma3 nails.MATERIALS AND METHODS: A review of 162 patients (both male and female) treated for intertrochanteric fractures between December 2012 and December 2018 was conducted. All patients were older than 65 years of age and treated with U-blade Gamma3 (n=90) or Gamma3 (n=72) nails. Evaluations included: (i) screw-head position, (ii) fracture-reduction status, (iii) time to union, (iv) cases of cut-out, (v) tip-apex distance, and (vi) lag screw sliding distance. Differences in pre- and postoperative ambulatory ability was also investigated.RESULTS: There were no significant differences in baseline demographics between the two groups. While the lag-screw sliding distance was significantly shorter in U-blade Gamma3 nail group (4.7 mm vs. 3.6 mm; P=0.025), the mean time to union was similar between the groups (P=0.053). Three and six cases of cut-out were noted in the U-blade Gamma3 and Gamma3 nail groups, respectively (P=0.18), however no other postoperative complications were noted in either group. Lastly, there was no difference between the change from pre- to postoperative activity level between the groups (P=0.753).CONCLUSION: Of all the clinical and radiological outcomes assessed, the only significant improvement between those treated with U-Blade Gamma and Gamma3 nails was a shorter lag-screw sliding distance. These findings should benefit clinicians when deciding between the use of U-Blade Gamma or Gamma3 nails.
Subject(s)
Humans , Male , Demography , Femur , Hip Fractures , Postoperative ComplicationsABSTRACT
PURPOSE: This study was performed to assess the radiologic and clinical results of U-blade Gamma3 nail use for the treatment of trochanteric fractures. MATERIALS AND METHODS: Between September 2015 and May 2018, all patients aged 65 years and older who underwent surgery with U-blade Gamma3 nails were analyzed. A total of 129 patients were selected based on having at least six months of follow-up. Image evaluations included bone quality (T-score), fracture classification on plain radiograph (AO/OTA), computed tomography configuration, union period, position of lag screw, anatomical reduction, tip apex distance (TAD), sliding extent of lag screw, change of neck shaft angle, and complications leading to reoperations were analyzed. Functional outcome were assessed using the Koval grade (ambulatory ability) at the final follow-up. RESULTS: The mean time to union was 19.7 (range, 6–36) weeks. The screw position was centric (93 cases; 72.1%) and anatomical reduction was achieved in 74 cases (57.4%). The mean TAD was 20.3 (range, 12.3–38.1) mm. The mean sliding length of the lag screws was 3.8 (range, 0.1–12.6) mm. The mean change of neck shaft angle was 3.4° (range, 0–12.8°). Reoperations were required in two cases (1.6%) due to the cutting out of the lag screw (n=1) and metal failure with U-blade bending (n=1). Finally, Koval grades for 49.8% of patients reached preoperative status. CONCLUSION: Overall, use of the U-blade Gamma3 nail led to favorable clinical results, suggesting that this system may be a good option for the treatment of trochanteric fractures.