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.
Highlights
Intertrochanteric femoral fractures occur between the greater and lesser trochanters and are commonly observed in the elderly[1]
There was no significant difference in the incidence of postoperative complications between the two groups (Supplemental Table 3). Both gamma nails and proximal femoral locking plate (PFLP) were used to treat unstable intertrochanteric femoral fractures with broken lateral walls, and the duration of surgery, intraoperative fluoroscopy frequency, total blood loss, hospitalized days, postoperative complications, and limb functional recovery were analyzed between two implant groups
The results indicated that both gamma nails and PFLPs are effective for unstable intertrochanteric femoral fractures with broken lateral walls for hip functional recovery
Summary
Intertrochanteric femoral fractures occur between the greater and lesser trochanters and are commonly observed in the elderly[1]. Previous studies have confirmed that fracture of the lateral trochanteric wall was the primary independent predictor of reoperation[17], and intertrochanteric femoral fractures are often treated with extramedullary fixation devices, such as dynamic hip screws, or intramedullary fixation devices, such as the gamma nail.
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