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Unstable subtrochanteric fractures—gamma nail versus dynamic condylar screw

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Abstract

We reviewed the operative treatment of subtrochanteric fractures. Before 1999, 15 fractures were treated with a dynamic condylar screw (DCS) and after 1999, 11 fractures were treated with a gamma nail (GN). The mean age of all patients was 70 (31–92) years, and the mean follow up was 16 (9–30) months for the DCS group and 14 (6–26) months for the GN group. All fractures united. There were no infections or implant cut out. In the DCS group, there was one malunion in varus and one late fracture of the implant. In the GN group, there was one malunion in internal rotation and three intraoperative fractures. Functional evaluation showed no significant differences in pain, range of movement, or walking ability, but recovery was significantly earlier in the GN group.

Résumé

Nous avons revus le traitement opératoire des fractures sous-trochantériennes. Avant 1999,15 fractures ont été traitées avec une vis dynamic condylar (DCS), et après 1999,11 fractures ont été traitées avec un clou gamma (GN). L'âge moyen de tous les malades était 70 ans (31–92) et le suivi moyen était de 16 mois (9–30) pour le groupe DCS et de 14 mois (6–26) pour le groupe GN. Toutes les fractures ont consolidé. Il n'y avait aucune infection ni démontage des implants. Dans le groupe DCS il y avait un cal vicieux en varus et une fracture tardive de l'implant. Dans le groupe GN il y avait un cal vicieux en rotation interne et trois fractures opératoires. L'évaluation fonctionnelle n'a pas montré de différences notables dans douleur, l'amplitude des mouvements ou les capacités de marche, mais la récupération était beaucoup plus précoce dans le groupe GN.

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  1. Department of Orthopaedics, Coquimbo Regional Hospital, Av. El Santo 1475, La Serena, Chile

    Andrés J. Pakuts

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  1. Andrés J. Pakuts
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Correspondence to Andrés J. Pakuts.

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Pakuts, A.J. Unstable subtrochanteric fractures—gamma nail versus dynamic condylar screw. International Orthopaedics (SICOT) 28, 21–24 (2004). https://doi.org/10.1007/s00264-003-0497-y

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  • DOI: https://doi.org/10.1007/s00264-003-0497-y

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