Trochanteric Fractures Clinical Trial
Official title:
Results of Gamma Nail in Trochentric Fractures of the Adults
We prospectively reviewed the results of 30 patients who had undergone intramedullary fixation with a gamma nail for femur trochentric fractures in AUH. within 1 year
Hip fractures are considered one of the major health problems in aging societies . These
fractures are correlated with increased disability and mortality and a decreased quality of
life . Early mobilization of patients with these fractures is essential to improve fracture
healing, minimize immediate postsurgical morbidity, and reduce care costs. One essential
prerequisite for early mobilization is mechanically stable fracture fixation . Nowadays, most
hip fractures are treated by extramedullary or intramedullary implants, which allow a stable
fixation in the majority of cases
A dynamic hip screw (DHS) is the most commonly used implant for intertrochanteric fractures .
Load bearing in the proximal femur is predominantly through the intact calcar femoral; the
lever arm of the laterally placed plate is increased, thus, there is a risk of implant cutout
if the calcar is not intact .
Biomechanically, compared with a laterally fixed side plate, an intramedullary device
decreases the bending force of the hip joint on the implant by 25-30%. This has advantages
especially in elderly patients, in whom the primary treatment goal is immediate full
weight-bearing mobilization.
It has been postulated that cephalomedullary nails have an advantage over DHS fixation
because of the load-bearing axis being closer to the hip joint fulcrum, and also less blood
loss, minimal tissue dissection, shorter operation time, and faster ambulation after surgery
. However, other studies have reported that fixation with DHS is better . One of the major
drawbacks discovered with the use of the gamma nail is a higher reoperation rate as a result
of new fracture around the implant . In this study, we present our results for the treatment
of trochentric fractures using a gamma nail in terms of the outcome, drawbacks, and possible
complications.
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