Rotationally stable screw anchor (RoSA) vs. Gamma3 Nail (G3N) in pertrochanteric femoral fractures : Afunctional outcome analysis

Abstract

The pertrochanteric femoral fracture (PFF) represents one of the most common fracture types throughout Germany. To enable early mobilization of patients, the primary surgical goal is load-stable osteosynthesis. Implant failure still represents the largest group of implant-related complications (>80%). The aim of the study was to document and analyze the influence of the implant on the functional outcome and an evaluation of the rotationally stable screw anchor (RoSA) vs. Gamma3 nail. In aretrospective study 43patients with PFF (AO 31A1-A3) were included in the study. The influence of the implant on the functional outcome was assessed by 2standardized questionnaires (SF-36, NMS (New Mobility Score)) and analyzed in aretrospective evaluation. In the study no significant differences in functional outcome scores ≥ 1year after osteosynthesis of the PFF could be shown depending on the implant used. There is an overall tendency for abetter outcome in the G3N group. In the literature the superiority of intramedullary nailing over extramedullary implants is continually discussed. Implant failure is still the most frequent complication. In intramedullary implants, such as the G3N, the primary cause is failure of the head-neck component. For conventional extramedullary implants the biomechanical properties on the femoral shaft also pose a challenge in the case of unstable PFF. The further development of the RoSA to an intramedullary implant could combine the advantages of intramedullary load carriers with the advantages of the blade-screw combination in the head-neck fragment and lead to a reduction in implant-associated complications.