Percutaneous treatment of peritrochanteric fractures using the Gamma nail.

Overview

The goal of the current study was to analyze patients treated with the Gamma nail, and to describe techniques that prevent commonly reported complications. One hundred patients with closed peritrochanteric femur fractures were treated by one surgeon using the Gamma nail. Ninety patients met the minimum 6 month followup requirement. Eighty-eight of the 90 fractures (98%) healed after the index procedure. There were nine (10%) complications (nine patients) with four patients (4%) requiring surgical intervention. One patient required total hip arthroplasty because of nonunion, and one patient required cerclage wiring of a postoperative femoral fracture. The third patient had an infection develop which resolved after debridement and a course of antibiotics. The fourth patient complained of thigh pain, which resulted in hardware removal. In the five remaining patients with complications, one patient had multi-infarct dementia and the family refused additional treatment, two patients with intraoperative femur fractures did not require treatment and two patients with thigh pain did not require additional treatment. Surgical time averaged 53 minutes and blood loss averaged 104 cc. Percutaneous fixation using the Gamma nail is effective in treating patients with peritrochanteric fractures. Surgical time and blood loss were minimized, early weightbearing was initiated, and previously reported complications were decreased.