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Gamma nail

Ana Costa Pinheiro, Bruno Alpoim, António Félix, Carlos Alves, Cristina Sousa, António Rodrigues
Intertrochanteric femur fractures are very common in patients over 65 years old, and are often associated with osteoporosis. Proximal femoral nails are preferred because of their biomechanical advantages in the treatment of these fractures, especially if the fracture is unstable. However, many complications associated with intramedullary fracture fixation have been described. The medial migration of the intramedullary gamma nail is a rare complication. The authors report an uncommon but potentially fatal complication, medial and intrapelvic migration of the intramedullary Gamma 3 nails, recorded after one month of osteosynthesis...
November 2016: Revista Brasileira de Ortopedia
Sun-Jun Hu, Shi-Min Chang, Zhuo Ma, Shou-Chao Du, Liang-Ping Xiong, Xin Wang
BACKGROUND: The treatment of proximal femoral fractures in geriatric osteoporotic patients continues to be a challenge in orthopaedic trauma. Various kinds of cephalomedullary nails, such as gamma nail, InterTan and PFNA were used clinically. The latest generation PFNA II, specially designed for Asian population, is commonly used for geriatric per-/intertrochanteric fractures. The aim of this study was to determine whether the current PFNA-II proximal segment length is suitable for the greater trochanter height, as assessed by postoperative radiograph measurements...
November 2016: Indian Journal of Orthopaedics
N W Lang, C Arthold, J Joestl, A Gormasz, S Boesmueller, S Hajdu, K Sarahrudi
INTRODUCTION: Poor bone quality and unstable fractures increase the cut-out rate in implants with gliding lag screws. The U-Blade (RC) lag screw for the Gamma3(®) nail was introduced to provide monoaxial rotational stability of the femoral head and neck fragment. The purpose of this study was to evaluate whether the use of the U-Blade (RC) lag screw is associated with reduced cut-out in patients with OTA/AO 31A1-3 fractures. MATERIAL & METHODS: Between 2009 and 2014, 751 patients with OTA/AO 31A1-3 fractures were treated with a Gamma3(®) nail at our institution...
December 2016: Injury
S Hopp, R Wirbel, I Ojodu, A Pizanis, T Pohlemann, J Fleischer
The aim of this study was to compare two proximal femur nails with regard to the complication rate and midterm clinical outcome : the InterTAN nail (ITN) versus the third generation gamma nail (GN). 78 patients older than 60 years with an unstable intertrochanteric femoral fracture (AO/OTA 31 A2/A3) were randomised over a 20 month period into either ITN (n = 39) or GN (n = 39). The outcomes of interest were the perioperative implant-related complications and the functional status (Harris Hip Score) at 6 months postoperatively...
August 2016: Acta Orthopaedica Belgica
Yun-gen Hu, Lei Han, Wei-li Fang, Bo Jin
OBJECTIVE: To compare clinical efficacy of anatomic locking plate and Gamma nail in treating unstable femoral intertrochanteric fractures with external wall fractures. METHODS: From June 2010 to June 2014,clinical data of 44 patients with intertroehanteric fractures associated with lateral wall fractures (type 31A2.2-3.3) followed more than 12 months,which treated with Gamma nail or anatomic locking plate,were retrospective analyzed. Sixteen patients were treated with anatomic locking plate, including 6 males and 10 females aged from 32 to 83 years old with an average of 56...
June 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Kainan Li, Yingjie Zheng
OBJECTIVE: To retrospectively evaluated Gamma nail internal fixation in the treatment of elderly patients with post-stroke hemiplegia experiencing trochanteric hip fracture. METHODS: The patients were obtained consecutively from January 2005 to December 2010 with inclusion criteria. The total number was 138 and allocated to two groups: treated with the Gamma nail (n=72,group A) and continuous skin traction (n=66,group B). Preoperative variables including patient age, gender, duration of cerebrovascular accident, duration of hypertension, ASA risk score, Harris hip score and fracture type were recorded and compared...
October 2016: Injury
Zenaiun Liu, Hengsheng Shu, Xu Chen, Feng Guo, Kegang Zhang, Yabin Liu, Bowen Shi
OBJECTIVE: To evaluate the effectiveness of Othofix pertrochanteric fixator for fixation of intertrochanteric fracture. METHODS: A retrospective analysis was made on the clinical data from 36 cases of intertrochanteric fracture treated with Othofix pertrochanteric fixator (OPF group) and 47 cases treated with Gamma nail (Gamma group) between October 2012 and March 2015. There was no significant difference in gender, age, cause of injury, side, AO fracture classification, combined medical disease, and injury to operation time between 2 groups (P > 0...
April 2016: Chinese Journal of Reparative and Reconstructive Surgery
S van Hoef, M C H W Fuchs, R H M Ten Broeke
An 81-year-old female was treated for a pertrochanteric multifragmentary fracture of the proximal femur with a third-generation Gamma nail. After 3 months she presented herself again with acute pain and inability to bear weight on the leg. Radiographs showed medial migration of the lag screw. She was treated with a total hip arthroplasty, after which she was successfully discharged. In this case report the possible causes of this late and unusual complication are discussed.
2016: Case Reports in Orthopedics
Vito Di Lernia
Lichen planus is a chronic inflammatory disease of the skin, mucous membranes and nails. Management of oral involvement, particularly atrophic and erosive lesions, is challenging. Noteworthy, there is a lack of published evidence for treatment. Cell-mediated cytotoxicity is actually regarded as a major mechanism of pathogenesis. The interferon-gamma induced chemokines CXCL10 and CXCL9 are strongly expressed in serum of patients as well as in both skin and mucosal lesions. Therefore the interferon gamma/CXCL10 axis is considered a key process for both progression and maintenance of chronic cytotoxic inflammation...
July 2016: Medical Hypotheses
Mouhcine Sbiyaa, Adil El Alaoui, Mohammed Admi, Kamal Lahrach, Amine Marzouki, Fawzi Boutayeb
Failure of internal fixation of intertrochanteric fracture is associated with delayed union or malunion resulting in persistent pain and diminished function. We report a rare case of implant failure of the gamma nail with intertrochanteric fracture non union treated by DCS plate screw and bone graft.
2016: Pan African Medical Journal
Xue-Feng Guo, Ke-Ming Zhang, Hong-Bo Fu, Wen Cao, Qiang Dong
PURPOSE: To compare the clinical effects of long vs. short intramedullary nails in the treatment of intertrochanteric fractures in old patients more than 65 years old. METHODS: A retrospective analysis of 178 cases of intertrochanteric fractures of the femur (AO type A1 and A2) in the elderly was conducted from January 2008 to December 2013. There were 85 males (47.8%) and 93 females (52.2%) with the age of 65e89 (70.2±10.8) years. The patients were treated by closed reduction and long or short intramedullary nail (Gamma 3) fixation...
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Bogdan Deleanu, Radu Prejbeanu, Dinu Vermesan, Lucian Honcea, Mihail Lazar Mioc, Eleftherios Tsiridis, Vlad Predescu
INTRODUCTION: The avascular necrosis of the femoral head represents the death of bone tissue due to the lack of blood supply. The disease has a progressive evolution and left untreated leads to femoral head collapse and severe arthritis. CASE PRESENTATION: We present a case of a pertrochanteric fracture which has been successfully operated with a dynamic interlocking trochanteric gamma nail on the right hip. At 2 years after surgery the patient developed an incipient avascular necrosis of the femoral head...
February 2016: Annals of Medicine and Surgery
Lorenzo Andreani, Enrico Bonicoli, Nicola Piolanti, Paolo Parchi, Francesco Niccolai, Alessandra Carmignani, Michele Lisanti
The purpose of this prospective randomized trial was to assess whether an intramedullary nail is superior or not to another one in the treatment of pertrochanteric fractures. Eighty-one patients with a 31-A1 or A2 Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) pertrochanteric fracture were randomly allocated to fixation with either the Gamma® or the ENDOVIS® nail. In order to estimate the functional outcome the Parker-Palmer mobility score, Barthel Index, and EuroQol-5D (EQ-5D) were used...
November 2015: Surgical Technology International
Jiajie Yu, Chao Zhang, Ling Li, Joey S W Kwong, Li Xue, Xiantao Zeng, Li Tang, Youping Li, Xin Sun
The relative effects of internal fixation strategies for intertrochanteric fracture after operation remain uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to address this important issue. We searched PubMed, EMBASE and CENTRAL for RCTs that compared different internal fixation implants in patients with intertrochanteric fracture at 6-month follow-up or longer. We ultimately included 43 trials enrolling 6911 patients; most trials were small in sample sizes and events...
December 11, 2015: Scientific Reports
Sara Sciacca, Surjit Singh Lidder, Christoph Grechenig, Stephan Grechenig, Mario Staresinic, Bore Bakota, Axel Gänsslen
INTRODUCTION: Different modalities of treatment for hip fractures have been discussed in the literature; however, practice may vary between centres. A survey was conducted on participants at an international AO course to assess the current management of pertrochanteric fractures (AO/OTA 31-A2) and displaced, non-impacted, subcapital fractures (AO/OTA 31-B3) in a 35-year-old patient and an 85-year-old patient. METHODS: Surgeons taking part in an international orthopaedic course were invited to participate in a survey and were divided into two groups: inexperienced (one-to-three years since qualification) and experienced (four or more years)...
November 2015: Injury
Lorenzo Andreani, Enrico Bonicoli, Nicola Piolanti, Francesco Niccolai, Alessandra Carmignani, Michele Lisanti
The purpose of this prospective randomized trial was to assess whether an intramedullary nail is superior or not to another one in the treatment of pertrochanteric fractures. Eighty-one patients with a 31-A1 or A2 Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) pertrochanteric fracture were randomly allocated to fixation with either the Gamma® or the ENDOVIS® nail. In order to estimate the functional outcome the Parker-Palmer mobility score, Barthel Index, and EuroQol-5D (EQ-5D) were used...
October 7, 2015: Surgical Technology International
Nobuaki Chinzei, Takafumi Hiranaka, Takahiro Niikura, Mitsuo Tsuji, Ryosuke Kuroda, Minoru Doita, Masahiro Kurosaka
BACKGROUND: Recently, various femoral head fixation devices (HFDs) for trochanteric fractures have become available. However, there are some cases in which femoral head rotation with excessive sliding of the HFD is observed and it is often followed by cutout. The purpose of this study is to compare the ability of the three types of HFDs to prevent femoral head rotation. METHODS: Between July 2005 and December 2009, 206 patients aged over 60 years with trochanteric fractures who had undergone surgical treatment using a short femoral nail in our institution were enrolled into the study...
September 2015: Clinics in Orthopedic Surgery
Z L Stepanovic, B M Ristic
We report a case of 68-year-old female patient who suffered two Gamma 3 nail breakages following trochanteric fixation failure revision surgery. A patient was primarily treated with sliding hip screw. Revision surgeries of reverse trochanteric nonunion were performed with short Gamma 3 nails and bone grafting. The nail failures occurred 11 and 7 months after implantation. This undesired series of events were caused by inappropriate implant selection, thus replacing the nail to a modular total hip arthroplasty was more effective as salvage surgery...
2015: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
D Georgiannos, V Lampridis, I Bisbinas
BACKGROUND: Gamma nail was developed for the treatment of subtrochanteric hip fractures. Despite its advantages over extramedullary devices, gamma nail has been historically related to significant complications (implant breakage, femoral fractures at the tip of the nail). There is limited data to determine if the rate of these complications was minimized by using a new design of the gamma nail. Therefore we performed a case control study between the long gamma3 nail (LG3N) and the long trochanteric gamma nail (LTGN) to assess if: (1) the complication rate in the treatment of subtrochanteric fractures using the LG3N was lower than the one using the LTGN; (2) the reoperation rate was lower after using the LG3N...
October 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
Susanne Regus, Werner Lang
INTRODUCTION: Vascular complications after hip fracture are rare but can be life-threatening, especially in the elderly and if diagnosed late. PRESENTATION OF THE CASE: We report a false aneurysm of the calcified deep femoral artery after hip fracture and uneventful stabilization with a gamma nail, in an 85 year old woman. Three weeks after surgery there was swelling of the proximal thigh. Ultrasound scan revealed a false aneurysm of the deep femoral artery and plain X-ray showed a lesser trochanter fragment spiking the calcified deep femoral artery...
2015: International Journal of Surgery Case Reports
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