Published online Jul 16, 2014.
https://doi.org/10.12671/jkfs.2014.27.3.213
Results of Asian Type Gamma 3 Nail in Treatment of Trochanteric Fractures
Abstract
Purpose
This study was conducted in order to demonstrate the radiologic and clinical results of using the Asian type gamma 3 nail in treatment of trochanteric fractures.
Materials and Methods
Patients underwent operations with gamma 3 nails between August 2010 and August 2012. For the radiologic evaluation, we analyzed bone quality, fracture pattern, reduction quality, union period, and position of lag screw (tip-apex distance, Cleveland index). For the clinical evaluation, we analyzed mobility score of Palmer and Parker and Jensen's functional score.
Results
The mean union was taken at 17.4 weeks (14-25 weeks). Two cases (4.3%) underwent reoperation due to cutting out of the hip screws. The clinical outcomes of Parker and Palmer's average mobility score changed from 7.3 to 5.8 (79%), Jensen's functional score was 1.3 to 1.8 (72%).
Conclusion
We achieved excellent clinical and radiological outcomes; therefore, Asian type gamma 3 nail is effective in treatment of trochanteric fractures of the femur in Korea.
Fig. 1
Photograph of Asia Pacific and Japanese version's gamma 3 nail.
Fig. 2
The patient is an 84-year-old female. (A, B) Preoperative radiograph shows an unstable fracture, AO A22. (C, D) Immediate postoperative x-ray shows relatively good reduction, but a lag screw was eccentrically positioned.
Fig. 3
(A) Radiograph shows a typical cut out of the femoral head at three months after the operation. (B) Cross table lateral x-ray.
Fig. 4
A 67-year-old female's hip shows AO type 32. (A, B) Preoperative radiograph shows a reverse pattern trochanteric fracture. (C, D) Postoperative x-ray shows unsatisfied reduction of the fracture.
Fig. 5
(A, B) Lag screw was cut out of the femoral head three months after the operation. (C, D) We converted bipolar hemiarthroplasty after removal of the gamma nail.
Fig. 6
Photograph of the sureshot guide, which was assembled to the troca.
Fig. 7
(A) Use of the sureshot guide to help determine proper nail positioning was shown under fluoroscopy. (B) Cross table lateral view.
Table 1
Preoperative Data (n=46)
Table 2
Mobility Score of Parker and Palmar
Table 3
Assessment of Social Function of Jensen
Financial support: None.
Conflict of interest: None.
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