Controlled study on Gamma nail and proximal femoral locking plate for unstable intertrochanteric femoral fractures with broken lateral wall

Lei Han, Jing-Jing Liu, Yun-Gen Hu, Ren-Fu Quan, Wei-Li Fang, Bo Jin, Wei-Long Lin, Lei Han, Jing-Jing Liu, Yun-Gen Hu, Ren-Fu Quan, Wei-Li Fang, Bo Jin, Wei-Long Lin

Abstract

The gamma nail and proximal femoral locking plate (PFLP) are both used for fractures. A controlled study was performed to determine the optimal implant. To assess and analyze the clinical effects of gamma nails and PFLPs for patients with unstable intertrochanteric femoral fractures, specifically with broken lateral walls. Thirty-six patients with unstable intertrochanteric femoral fractures and broken lateral walls were treated with gamma nails or PFLPs and retrospectively studied. The clinical data were compared. Duration of surgery and early full weight-bearing time were significantly longer in the PFLP group compared to the gamma nail group (P < 0.05). However, intraoperative fluoroscopy frequency and total blood loss in the PFLP group were significantly less than those in the gamma nail group (P < 0.05). No significant differences were found in hospitalized days, Parker Palmer mobility scores, Harris hip scores, and complications between the two groups. No difference in hip-functional recovery was found between the gamma nail group and the PFLP group, indicating that both the gamma nail and PFLP were effective for unstable intertrochanteric femoral fractures with a broken lateral wall. However, early weight bearing on the fractures was not encouraged in patients treated with PFLP.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
A 38-year-old male with right intertrochanteric fracture fixed with Gamma nail. (a) Radiograph of pelvis showed the fracture of right intertrochanteric, with broken lateral wall. (b,c) Anteroposterior and oblique plain film of right hip taken 2 weeks after surgery showed significant lateral wall defect. (d,e) Fracture healing was showed 6 months after surgery.
Figure 2
Figure 2
A 81-year-old female with right intertrochanteric fracture treated by proximal femoral locking plate (PFLP). (a) Radiograph of pelvis showed fracture of right intertrochanteric, with broken lateral wall. (b) Anteroposterior plain film of right hip taken 3 days after surgery showed satisfactory reduction of fracture. (c) Oblique plain film of right hip taken 3 days after surgery showed well aligned fracture, with stable internal fixation. (d,e) Fracture healing was showed in anteroposterior and oblique plain film of right hip taken 8 months after surgery.

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Source: PubMed

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