ArticleJB & JS open access2017
Implant-Related Complications and Mortality After Use of Short or Long Gamma Nail for Intertrochanteric and Subtrochanteric Fractures: A Prospective Study with Minimum 13-Year Follow-up.
Article in JB & JS open access, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Treating Intertrochanteric Fracture by Short and Long Cephalomedullary Nail: A Systematic Review and Meta-analysis.Malaysian orthopaedic journal · 2026Article
- Workspace and trajectory-based experimental validation of a 3-armed 6-DOF parallel robot for femoral fracture surgery.Frontiers in robotics and AI · 2026Article
- Initial construct stability of long cephalomedullary nails with superior locking for a complex trochanteric fracture model AO31A2.2- a biomechanical study.Journal of orthopaedic surgery and research · 2024Article
- What is the Optimal Nail Length to Treat Osteoporotic Subtrochanteric Fractures? A Finite Element Analysis.Clinics in orthopedic surgery · 2024Article
- Risk Factors for Therapeutic Failure and One-Year Mortality in Patients with Intramedullary Nail-Associated Infection after Trochanteric and Subtrochanteric Hip Fracture Repair.Antibiotics (Basel, Switzerland) · 2024Article
- The role of postoperative piriformis fossa and greater trochanter tubercle distance to predict cutout failure after cephalomedullary nail fixation.Journal of the Chinese Medical Association : JCMA · 2024Article
- Effect of Postoperative Non-Weight-Bearing in Trochanteric Fracture of the Femur: A Retrospective Cohort Study Using Propensity Score Matching.Geriatric orthopaedic surgery & rehabilitation · 2023Article
- New Prognostic Factors in Operated Extracapsular Hip Fractures: Infection and GammaTScore.International journal of environmental research and public health · 2022Article
- Impact of subtrochanteric fractures in the geriatric population: better pre-fracture condition but poorer outcome than pertrochanteric fractures: evidence from the Spanish Hip Fracture Registry.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2022Observational
- Biomechanical study on the stability and strain conduction of intertrochanteric fracture fixed with proximal femoral nail antirotation versus triangular supporting intramedullary nail.International orthopaedics · 2022Article
- A comparative Study of Novel Extramedullary Fixation and Dynamic Hip Screw in the Fixation of Intertrochanteric Fracture: A Finite-Element Analysis.Frontiers in surgery · 2022Article
- External Locking Plate Fixation for Femoral Subtrochanteric Fractures.Geriatric orthopaedic surgery & rehabilitation · 2022Article
- Subtrochanteric femoral fractures: A case series of 194 patients treated with long and short intramedullary nails.Orthopedic reviews · 2022Article
- Long-term outcomes of distal locking in extracapsular fractures treated with trochanteric Gamma3 nails.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2021Article
- Bent or broken: analysis of set screw fracture in the TFNa implant.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2021Article
- Titanium Alloy Gamma Nail versus Biodegradable Magnesium Alloy Bionic Gamma Nail for Treating Intertrochanteric Fractures: A Finite Element Analysis.Orthopaedic surgery · 2021Article
- Medial Calcar Comminution and Intramedullary Nail Failure in Unstable Geriatric Trochanteric Hip Fractures.Medicina (Kaunas, Lithuania) · 2021Article
- Subtrochanteric femur fractures: current review of management.EFORT open reviews · 2021Review
- Biomechanics of subtrochanteric fracture fixation using short cephalomedullary nails: A finite element analysis.PloS one · 2021Article
- Clinical Outcomes of Intermediate-Length Cephalomedullary Nails for Intertrochanteric Femur Fracture Repair in Older Adults.Kansas journal of medicine · 2020Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe purpose of this study was to evaluate the rates of implant-related complications and mortality after treatment of an intertrochanteric or subtrochanteric fracture with a short or long Gamma nail.
methodsBetween September 1998 and August 2003, 644 patients at 2 centers treated with a long or short Gamma nail for a hip fracture were prospectively enrolled in this study. These patients were followed until they reached 1 of the study end points, which included death, a reoperation directly related to the Gamma nail, or the end date of the study.
resultsThe average age (and standard deviation) of the patients included in the study was 81.3 ± 8.6 years at the time of the operation, and 28.3% of the patients were male. The rate of implant-related complications was 9.9%. The most common complications included peri-implant fracture (4.2%), proximal lateral thigh discomfort requiring extraction of the implant (2.0%), and lag-screw cutout (1.1%). Interestingly, more than half (56%) of the 27 peri-implant fractures occurred >1.5 years after the index operation. The median time from the operation to death was 2.9 years (range, 0 to 17.1 years). The 30-day mortality rate after treatment was 9.5%. Patients with American Society of Anesthesiologists (ASA) class-3 or 4 physical status had a significantly higher risk of mortality than ASA class-1 patients.
conclusionsGamma nails are effective in the treatment of intertrochanteric and subtrochanteric fractures. However, 9.8% of patients had complications requiring additional surgery. The most common serious complications include peri-implant fracture and lag-screw cutout. Several peri-implant fractures occurred long after the index procedure. Patients had a high rate of mortality (27%) after 1 year, and higher preoperative ASA class was found to be a predictor of increased risk of mortality. Therefore, clinicians must carefully consider patients' preoperative comorbidities when counselling patients on the risks of surgery. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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