Treatment of per- and subtrochanteric femur fractures using the gamma nail

Background: From 1992 through 1997 96 patients with per- or subtrochanteric femur fractures were treated with a Gamma nail. We retrospectively evaluat ed the influence of patient age, additional diseases, type of fracture, tim e of operation, type of implant (short/long Gamma nail) and surgical approa ch (open/closed reduction) on the mobility of the patients, healing of the fractures on radiographs, and possible complications. Patients and methods: The average patient age was 72.5 years (range 27 to 101). There were 27 ma le and 69 female patients. Surgery was performed 1.19 (0-10) days after inj ury. At 3, 6, and 12 months after surgery radiographs of the involved hip j oint and femur were obtained and the degree of mobility was assessed. Resul ts: Additional diseases, type of fracture, time of operation, type of impla nt (short/long Gamma nail) and surgical approach (open/closed reduction) di d not influence mobility of the patients, healing of the fractures on radio graphs or rate of complications. It was more difficult to mobilize older pa tients (P < 0.001). After 1 year 97% of all fractures had healed on radiogr aphs. In 15 patients (18%) complications occurred due to technical errors u sing the Gamma nail. Discussion: With the Gamma nail stable osteosynthesis of per-and subtrochanteric femur fractures is obtained independently of the fracture classification. Patients can be mobilized immediately. Technical errors must be avoided.