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General Orthopaedics

OUTCOMES OF THE 3RD GENERATION GAMMA NAIL: DIFFERENCES IN OUTCOME IN USING THE LONG AND SHORT GAMMA NAILS

The Indian Orthopaedic Society (UK) (IOSUK)



Abstract

Introduction

The gamma nail is a cephalomedullary implant used in proximal femoral fracture management. Short gamma nails are technically less demanding, but there is concern over potentially higher complication rate.

Objectives

To determine differences in implant related complications between the short and long gamma nail.

Methods

54 patients were identified who had either short or long gamma nail for a proximal femoral fracture. Case notes and radiographs were reviewed retrospectively to determine the complication rate due to implant failure. Fisher's exact test was used for testing the significance.

Results

Out of 54 patients, 20 patients had short gamma and 34 patients had long gamma nail. 4 (20%) patients with short gamma nail had implant related complications whereas none in the long gamma nail group (P<.05). 2 (10%) patients had fracture of the nail at the level of proximal screw, 1 (5%) patient had cut out of the screw from the femoral head and 1 (5%) patient had fracture below the tip of the nail.

Conclusions

Our study suggests short gamma nails are associated with higher rate of implant related complications and we now routinely use long gamma nails whenever indicated.