Treatment of trochanteric femoral fracture by gamma nail and modular hip prostheses. Indication and results

From January 1997 to August 1998 all stabel and nonstabel trochanteric femo ral fractures (n = 72) were treated routinely by gamma nail using the corre ct operative technique. Patients showing additional osteoarthritis of the h ip in radiographs hip replacement was performed by a cementless modular fem oral hip prostheses from January 1996 to August 1998 (n = 28). Follow up pe riod was 6 to 18 months. Operation time and blood loss were higher using th e prostheses. However complications and letality (<5%) were not different d uring postoperativ course. In each group three operative technical complica tions occured. Using a modified Harris Hip Score (without range of motion, contractions) the score was decreased non significant comparing both groups first of all in unstabel fractures until follow up. In each group one revi sion (loosening of prostheses, excessive shortening of femoral neck) was ne cessary. Using the correct operative technique, the gamma nail prooved to b e a save device with good outcome. Outcome using modular prostheses is comp arable to gamma nail. Therefore the use of modular prostheses is justified in case of osteoarthrosis and in some cases of very unstable fracture.