Hip Pelvis.  2020 Mar;32(1):50-57. 10.5371/hp.2020.32.1.50.

A Comparison of U-blade Gamma3 and Gamma3 Nails Used for the Treatment of Intertrochanteric Fractures

Affiliations
  • 1Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Korea. hananina@seoulmc.or.kr
  • 2Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea.

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.

Keyword

Femur; Intertrochanteric fractures; Gamma3 nail; U-blade

MeSH Terms

Demography
Femur
Hip Fractures*
Humans
Male
Postoperative Complications

Figure

  • Fig. 1 (A) Anteroposterior view of intertrochanteric fracture treated with U-blade Gamma3 nail. (B) Trans-lateral view of intertrochanteric fracture treated with U-blade Gamma3 nail. (C) Photograph of U-blade Gamma3 nail.

  • Fig. 2 (A) Postoperative anteroposterior radiographs at 1 year of a 97-year-old male with U-blade Gamma3 nail showed fixation failure and blade cut-out through the femoral head into the acetabulum. (B) Revised to a total hip arthroplasty and had returned to walk independently.


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