Clinical effects of locking gamma nail versus modified gamma nail for treatment of unstable intertrochanteric femoral fractures in elderly patients

Abstract

Objective To compare the clinical effects of locking gamma nail (LGN) with modified gamma nail (MGN) in the management of unstable intertrochanteric femoral fractures in elderly patients. Methods A total of 143 elderly patients with unstable intertrochanteric femoral fractures who were treated with LGN (n = 67) or MGN (n = 76) at the 118th Hospital of PLA from January 2008 to May 2012 and had complete clinical data were retrospectively studied. We compare the two groups in terms of fracture healing time, Harris hip score, degree of fracture compression, and variation of Neck shaft angle. Continuous variables (fracture healing time, Harris hip score, and the degree of fracture compression) were compared using the paired t-test, and comparison of categorical variables (the change of Neck shaft angle) was performed using the chi-squared test. Results All of the patients were followed successfully. Compared with the MGN group, the LGN group had significantly longer fracture healing time [(16.8 ± 7.4) weeks vs (14.4 ± 6.6) weeks], less variation of neck-shaft angle (3.0% vs 14.5%), lower degree of fracture compression [(4.4 ± 2.5) mm vs (7.3 ± 3.1) mm], and higher Harris hip score [(86.6 ± 6.3) scores vs (83.1 ± 6.7) scores] (P < 0.05 for all). Conclusion Both LGN and MGN are effective in the management of unstable intertrochanteric femoral fractures in elderly patients, but LGN has more advantages in preventing compression of fracture end and recovery of hip joint function compared to MGN. Key words: Intertrochanteric femoral fractures; Unstable; Elderly patients; Locking gamma nail; Internal fixation