Results of Asian Type Gamma 3 Nail in Treatment of Trochanteric Fractures

Bing Zhe Huang; Yong Wook Park; Jin Su Park; Kyu Cheol Noh; Soung Yon Kim; Kook Jin Chung; Hong Kyun Kim; Hyong Nyun Kim; Yong Hyun Yoon; Ji Hyo Hwang

doi:10.12671/jkfs.2014.27.3.213

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Huang, Park, Park, Noh, Kim, Chung, Kim, Kim, Yoon, and Hwang: Results of Asian Type Gamma 3 Nail in Treatment of Trochanteric Fractures

Original Article

Journal of the Korean Fracture Society 2014; 27(3): 213-221.

Published online: 16 July 2014

DOI: https://doi.org/10.12671/jkfs.2014.27.3.213

Results of Asian Type Gamma 3 Nail in Treatment of Trochanteric Fractures

Bing Zhe Huang, M.D., Yong Wook Park, M.D., Jin Su Park, M.D., Kyu Cheol Noh, M.D., Soung Yon Kim, M.D., Kook Jin Chung, M.D., Hong Kyun Kim, M.D., Hyong Nyun Kim, M.D., Yong Hyun Yoon, M.D., Ji Hyo Hwang, M.D., Ph.D.

Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

Address reprint requests to: Ji Hyo Hwang, M.D., Ph.D. Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 150-950, Korea. Tel: 82-2-829-5165, Fax: 82-2-834-1728, hwangjihyo7309@gmail.com

Received 26 November 2013 Revised 30 May 2014 Accepted 30 May 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was conducted in order to demonstrate the radiologic and clinical results of using the Asian type gamma 3 nail in treatment of trochanteric fractures.

Materials and Methods

Patients underwent operations with gamma 3 nails between August 2010 and August 2012. For the radiologic evaluation, we analyzed bone quality, fracture pattern, reduction quality, union period, and position of lag screw (tip-apex distance, Cleveland index). For the clinical evaluation, we analyzed mobility score of Palmer and Parker and Jensen's functional score.

Results

The mean union was taken at 17.4 weeks (14-25 weeks). Two cases (4.3%) underwent reoperation due to cutting out of the hip screws. The clinical outcomes of Parker and Palmer's average mobility score changed from 7.3 to 5.8 (79%), Jensen's functional score was 1.3 to 1.8 (72%).

Conclusion

We achieved excellent clinical and radiological outcomes; therefore, Asian type gamma 3 nail is effective in treatment of trochanteric fractures of the femur in Korea.

Keywords: Femur, Trochanteric fracture, Gamma nail

Figures and Tables

Fig. 1

Photograph of Asia Pacific and Japanese version's gamma 3 nail.

Fig. 2

The patient is an 84-year-old female. (A, B) Preoperative radiograph shows an unstable fracture, AO A22. (C, D) Immediate postoperative x-ray shows relatively good reduction, but a lag screw was eccentrically positioned.

Fig. 3

(A) Radiograph shows a typical cut out of the femoral head at three months after the operation. (B) Cross table lateral x-ray.

Fig. 4

A 67-year-old female's hip shows AO type 32. (A, B) Preoperative radiograph shows a reverse pattern trochanteric fracture. (C, D) Postoperative x-ray shows unsatisfied reduction of the fracture.

Fig. 5

(A, B) Lag screw was cut out of the femoral head three months after the operation. (C, D) We converted bipolar hemiarthroplasty after removal of the gamma nail.

Fig. 6

Photograph of the sureshot guide, which was assembled to the troca.

Fig. 7

(A) Use of the sureshot guide to help determine proper nail positioning was shown under fluoroscopy. (B) Cross table lateral view.

Table 1

Preoperative Data (n=46)

Table 2

Mobility Score of Parker and Palmar

Table 3

Assessment of Social Function of Jensen

Notes

Financial support: None.

Conflict of interest: None.

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