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Treatment of stable extra-capsular hip fractures with a sliding screw versus short gamma nail: a retrospective study of 102 patients

  • Abhay R. Patel
  • Chris Boyes
  • Vladimir ShurEmail author
Original Article

Abstract

This is a retrospective study of 102 patients with intertrochanteric hip fractures comparing the operative results of short gamma nail™ fixation with the sliding hip screw. The average patient age in the study is 83 years (range 52–94 years) with 87% females. The transfusion requirements between the two groups did not differ but a slightly larger decrease in hemoglobin levels was seen at 48 h in the gamma nail group. In neither group were there any intra-operative fractures or infections which led to a return to the operating room. The average length of stay for both groups was identical at 6.9 days. Twenty-seven short gamma nail patients and 18 compression hip screw patients were followed for 6 months. There were no instances of cut-out in either group but the short gamma nail group had middle/middle lag screw placement on the AP and lateral views more often than the compression hip screw (50%) group at 6 months. We conclude that the short gamma nail can be used effectively for the fixation of intertrochanteric hip fractures without the occurrence of potentially devastating complications such as intraoperative femur fracture, periprosthetic fracture or lag screw cut-out.

Keywords

Intertrochanteric fractures Femur Hip Locking nailing Lag screws 

Vissage versus enclouage gamma dans les fractures de la hanche

Résumé

Les auteurs présentent une étude rétrospective de 102 patients avec fracture inter-trochantérienne, comparant les résultats opératoires de l’enclouage avec clou Gamma court et du vissage par vis coulissante à compression. L’âge moyen des patients était de 83 ans (extrêmes 52–94) avec 87% de femmes. Les besoins transfusionnels entre les deux groupes ne montraient guère de différences, si ce n’est une très légère augmentation de la perte d’hémoglobine au bout de 48 heures dans le groupe des enclouages avec clou Gamma. Il n’y eut ni fractures per-opératoires ni infections nécessitant le retour en salle d’opération dans aucun des deux groupes. Le séjour moyen était identique dans les deux groupes, soit 6.9 jours. 27 cas de clous Gamma et 18 de vissages ont pu être suivis pendant 6 mois. Il n’y eut aucun cas de dévissage dans les deux groupes, mais le groupe des clous Gamma courts comportait un plus grand nombre de positions centrées de la vis à compression sur les contrôles radiologiques antéro-postérieures et de profil, effectués à six mois, que le groupe des vissages seuls (50%). Les auteurs concluent que l’enclouage avec des clous Gammas courts peut être utilisé de façon efficace pour la fixation des fractures inter-trochantériennes sans risque de complications graves, telles des fractures per-opératoires du fémur, ou des fractures autour des implants ou encore des dévissages.

Mots clés

Fractures inter-trochantériennes Fémur Hanche Enclouage verrouillé Vis à compression 

Notes

Acknowledgements

The authors thank Dr. Joseph Feliccia and Dr. Howard Goodman for their assistance in creating and editing this study. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryMaimonides Medical CenterBrooklynUSA

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