Pdf trochanteric gamma nail and compression hip screw. Note as template magnification levels are set at 117%, all measurements are estimates of true size. Four months later she developed pain in her left hip area and check radiographs confirmed a failure of the gamma nail through the insertion. The evolution of the successful trochanteric and long gamma nails as well as the asia pacific and japanese versions followed strictly a stepbystep.
To facilitate conformity with the human anatomy, the long nail is supplied in a. A prospective randomized study was used to compare the ambi hip screw and the gamma nail for the treatment of 69 patients over the age of 50 years. It has been evolved, from the kuntscher y nail 4, by grosse strasbourg, in conjunction with howmedica. The nail is cannulated for guidewirecontrolled insertion. The gamma nail ensures immediate stability permitting early mobilization and weightbearing, limited only by the patients general condition. Gamma3 nail 180 the anatomical shape of the nail is universal for all indications involving the treatment of trochanteric fractures. Original article a comparative study of long thirdgeneration. A controlled study was performed to determine the optimal implant. Gamma nail in both types of fractures shared the smaller displacement. Femoral universal femoral universal nailing system options. Femoral universal nails are available in 1 mm increments from 9 mm to 15 mm diameters. It usually requires surgery and months of physical therapy.
The medical implant is mainly fabricated using stainless steel and titanium alloys for strength and the plastic coating that is done on it acts as an artificial cartilage. Controlled study on gamma nail and proximal femoral locking. Mar 28, 2011 this 3d medical animation features a dramatic surgical overview during the operative placement of an intramedullary nail into the right leg to secure a comminuted femur fracture. Gamma3 nail 170 and 180 the anatomical shape of the nail is universal for all indications involving the treatment of trochanteric fractures. The nail features a small proximal section that is designed to minimize the amount of bone that must be removed for nail insertion. A comparative study of long thirdgeneration gamma nail and long proximal femoral nail antirotation in the treatment of subtrochanteric femoral fracture maofeng gao, ruofu zhu, weidong shi, huilin yang orthopaedic institute, the first affiliated hospital of soochow university, shizi 188 st. Pdf fixation of intertrochanteric fractures of the femur. Trochanteric and long gamma nails as well as the asia pacific and japanese. The gamma3 locking nail system is based on more than 20 years of gamma nail experience.
The gamma3 locking nail system is based on more than 16 years of gamma nail experience. Nail dynamization for delayed union and nonunion in femur and tibia fractures. Pdf gamma nails have been used extensively for the treatment of proximal femoral fractures. Stryker gamma nail to treat a hip intertrochanteric fracture youtube. The resultant force is transmitted directly down the femur using a nail system. This is the third generation of gamma intramedullary short and long fixation nails. The gamma nail has been introduced as an advance over the ambi hip screw in intertrochanteric femoral fractures.
Retrograde femoral nailing has expanded the use of intramedullary nails 1, 2. The gamma3 locking nail system was developed based on more than 15 years of gamma nail experience. The evolution of the successful trochanteric and long gamma nails as well as. The gamma nail is designed for temporary implantation until the bone consolidation occurs. The evolution of the successful trochanteric and long gamma nails as well as the asia pacific and japanese versions followed strictly a step by.
The long gamma locking femoral cephalomedullary nail stryker trauma, geneva, switzerland was introduced in 1993. The gamma 3 nail is widely used for ao31a fractures. Trochanteric gamma nail and compression hip screw for trochanteric fractures. The aim of this study is to evaluate the management of pertrochanteric fractures of the femur using gamma nail asia pacific ap. Intramedullary nailing for femur fracture management. From january 2006 to december 2008 we conducted a prospective singlecenter study including 84 consecutive patients with pertrochanteric femoral fractures treated with either a gamma 3 nail gn strykerhowmedica, rutherford, nj the latest evolution of gamma device or a long gamma 3 nail lgn dyax. Intramedullary nailing of right femur fracture youtube. A series of 224 fractures of the proximal femur in which this nail was used is reported. A comparison of the long gamma nail with the sliding hip.
Barton tm, gleeson r, topliss c, greenwood r, harries wj, chesser tj. Surgical technique implant selection the trigen tan 71180884 and trigen fan 71180497 radiographic templates may be used to assist with preoperative implant selection. Is there a standard rehabilitation protocol after femoral in. Nail breakage at the level of the aperture of the lag. Surgical principles fractures of the neck of the femur and of the trochanteric region are typical injuries of the elderly. Role of gamma nail in management of pertrochanteric fractures. The nail is cannulated for guidewirecontrolled insertion and. Pdf controlled study on gamma nail and proximal femoral locking. Nail dynamization for delayed union and nonunion in femur. A randomized prospective comparison of the gamma nail and the dynamic hip screw. A range of three different neckshaft angles are available for lag screw entry to accommodate variations in femoral neck anatomy. Nail length, locking screw length and nail cap size may be determined. The gamma nail, a combination of advantages of the sliding screw with the intramedullary nail, represents an efficient technique in the management of these fractures.
An intertrochanteric fracture is a common hip fracture that happens most often in older adults. Nail breakage is a rare complication, possibly resulting from fatigue fracture of the implant. Stryker gamma nail to treat a hip intertrochanteric fracture. A femur fracture is typically sustained from highenergy impact such as motor vehicle collisions, falls from playground equipment, falls from furniture or resulting from a twisting mechanism. Gamma3 nail is intended for fixation of stable and unstable femoral fractures. Pdf the gamma nail and proximal femoral locking plate pflp are both used for fractures. Use of the gamma nail in the treatment of fractures of the. Sridhar durbhakula narrates a surgical procedures using trochanteric gamma nail and compression hip screw for trochanteric fractures. The evolution of the successful trochanteric and long gamma nails as well as the small stature versions followed strictly a step by step improvement based on the clinical. Current evidence suggests that a significant cohort of femur fracture patients managed with an intramedullary im nail will ultimately possess residual impairments and disability up to 3 years after surgery.
Internal fixation is an operation in orthopedics that. An 83yearold woman with an unstable trochanteric fracture of the femur was treated using a third generation gamma nail. Gamma is a comprehensive intramedullary nailing system for the treatment of a wide range of proximal femur fractures as well as associated femoral shaft. Therefore, if no bone consolidation occurs or if consolidation is not sufficient, the system may break. An orthopedic implant is a medical device manufactured to replace a missing joint or bone or to support a damaged bone. Pertrochanteric fractures pfs frequently affect the lower limb of osteoporotic patients and represent an important cause of morbidity and mortality in the elderly. Proximal femoral nail antirotation surgical technique pfna. Nov 28, 2018 however, long gamma nailing has a wellrecognized risk of anterior cortical abutment or perforation due to anatomical variations in the anterior bow of the femur and poor nail entry point. Jul 24, 2018 the gamma nail and proximal femoral locking plate pflp are both used for fractures. The aim of this study was to compare outcomes in patients with 31a2 fractures treated with two lengths of gamma3 nail. Its design is based on kuntschers ynail and locking intramedullary im nails.
Quality of life after pertrochanteric femoral fractures. The displacement of femurs fixed by gamma nail showed smaller displacement. Long nail all nails use the same lag screws, set screw, distal locking screws and end caps see fig. The nail is secured with a screw lower down the femur. Intramedullary nail of femur fracture activity do not bear weight on the operative leg until permitted by your surgeon. The nail is unslotted and cannulated for guidewirecontrolled insertion. Gamma3 long nail is intended for fixation of stable and unstable femoral fractures occurring from the base of the femoral neck extending distally to a point approximately 10cm proximal to the intracondylar notch including fractures of the basilar neck, intertrochanteric fractures, peritrochanteric fractures, subtrochanteric fractures and femoral shaft fractures. The t2 femoral nailing system offers a universal left and right nail in addition to an antegrade or retrograde approach that may reduce inventory. The advent of intramedullary nails for recon struction has provided a useful tool in the treatment of pathological fractures of the femur. The use of the long gamma nail in proximal femoral fractures. See instructions to authors for a complete description. Dec 18, 2019 elos nail is a reliable device on a shortterm followup and represents an alternative choice to the gamma 3 nail, a wellknown and appreciated system for over 25 years.
Intramedullary nailing for pertrochanteric fractures of. When compared with the long gamma nail, the sliding hip screw should remain the gold standard for the treatment of aoota 31a2 fractures of the proximal part of the femur because it is associated with similar outcomes with less expense. Results of its precursor, the standard gamma nail have previously been documented, 11 however, the long gamma nail lgn exhibits different mechanical characteristics and has different indications, therefore it should be considered as a different implant. The stress in the calcar region which was the main loadbearing area of the intact femoral neck was decreased markedly in all of the models, especially in model fixed with gamma nail. A lag screw is placed through the nail into the femoral head to secure the nail in place proximally and help control the different segments of the. You have had an intramedullary im nail or gamma nail which involves placing a. Nail length selection with the tip of the ball nose guide wire at the level of the desired depth of nail insertion, slide or snap the nail length. Patient sustained a fielding type ii a subtrochanteric non pathological fracture of her left femur which was which was fixed.
The nail design has been well proven in over 450 000 cases performed with the pfn and pfna. Sridhar durbhakula narrates a surgical procedures using trochanteric gamma nail and compression hip. However, in four cases fracture of the femur occurred close to the gamma nail, requiring further major surgery. Gamma nail in the treatment of closed trochanteric fractures. Its efficacy in an australasian setting has not been documented.
Original article biomechanical comparison of dynamic hip. The gamma nail combines the advantages of the two techniques most often used in the treatment of fractures of the proximal end of the femur. Do not engage in prolonged periods of standing or walking the first 710 days following surgery. The gamma nail is the latest advance in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures. Original study the long gamma nail for stabilisation of existing. Gamma3 nail 180 all nails use the same lag screws, set screw, distal locking screws and end caps see fig. We present the first reported case of breakage of a third generation gamma nail that was not used to treat a pathological fracture. If a sideplate system is used, the femur shaft may be weakened through a high number of locking screws.
Gamma3 nail long this nail incorporates several important mechanical design features. Pfna nail optimal fit the anatomical design guarantees an optimal. The t2 im nailing platform offers a combination of innovation, simplicity and versatility that is designed to suit your various needs. Complicated multiple trauma injuries, associated pelvic and acetabular fractures, ipsilateral femoral shaft fractures, supracondylar and intercondylar fractures, may be better. Pertrochanteric fractures which involve trochanteric fractures with varying fracture geometry pose a significant challenge to the treating orthopedic surgeon. The gamma3 locking nail system was developed based on more than. Trochanteric and long gamma nails as well as the asia pacific and. Stable fixation of these fractures can be obtained using a special intramedullary nail known as the gamma nail. A comparison of the long gamma nail with the sliding hip screw for the treatment of aoota 31a2 fractures of the proximal part of the femur. This paper reports the results from the firstever series of 121 patients operated between 1988 and 1990. The aim of postoperative care must be to ensure the promotion of bone consolidation.