Osteosynthesis of fractures of the trochanteric region using the gamma nail, apropos of 76 reviewed cases

The authors present 76 cases of trochanteric fractures, treated by a Gamma nail. The minimal follow-up was 6 months, with clinical and roentgenographical check-ups. The mean age was 74 years, with a female majority as classically; the most common cause was a simple fall. Unstable fractures represented 53% of the cases, with 39% subtrochanteric; nevertheless, full weight bearing was possible in 83% of the cases. The mechanical complications of this new technique have been studied in details and compared with other most common methods of osteosyntheses: the Ender rod and the sliding screw plate. The Gamma nail shows an uncontestable superiority compared to Ender's rods, but it has little advantage to D.H.S.-T.H.S., particularly because of the delay in full-weight bearing and deep infection rate. The Gamma nail moreover seems to be better adapted for the treatment of subtrochanteric fractures.