GAMMA-NAIL VS COMPRESSION SCREW FOR TROCHANTERIC FEMORAL FRACTURES - 15 REOPERATIONS IN A PROSPECTIVE, RANDOMIZED STUDY OF 378 PATIENTS

A total of 378 trochanteric and subtrochanteric femoral fractures were randomized to treatment with Gamma nail (177) or Hip Compression Scre w (HCS) (201). After a median follow-up time of 17 (10-27) months, 15 patients needed reoperations; 13 had been treated with Gamma nail and 2 with HCS. 10 patients, all treated with Gamma nail, were reoperated because of a femoral shaft fracture. 5 of these fractures occurred 8 ( 4-10) days postoperatively and were related to intraoperative complica tions. The other 5 shaft fractures occurred a median of 2 (1-3) months postoperatively after falls, and may be related to stress concentrati on at the tip of the solid nail. The lag screw cut out or penetrated t he femoral head in 5 patients, 3 of them treated with Gamma nail and 2 with HCS.