Treatment of Intertrochanteric Fractures of the Femur: Comparison of the Gamma Nail and the Dynamic Hip Screw

The Gamma nail has recently become available for the treatment of intertrochanteric femur fractures. We have reviewed our early experience using the Gamma nails on 35 cases of intertrochanteric femur fracture and compared the results with those of 38 cases of dynamic hip screw fixation. All the 73 cases were treated in Taegu Catholic University hospital in the period from January 1989 to January 1992. Gamma nails were implanted in significantly shorter operating time with less intraoperative bleeding. The differences of fracture union time and duration of hospital stay in two groups showed no significance by statistical analysis. Early full weight bearing was encouraged for the Gamma nail cases and this seemed to be beneficial for the old patients. Lateral cortical fracture and shaft fracture of the femur were important complications of the Gamma nail group. We experienced some technical difficulties in Gamma nail fixation, which seemed to be due to mismatching of the model to the orientals. We conclude that the Gamma nail is a useful internal fixator for the peritrochanteric fracture with wider indication including unstable or high subtrochanteric type.