Prospective comparative study of the intertrochanteric Gamma nail and AO proximal femoral nail in the treatment of unstable intertrochanteric fractures

Objective. Randomized prospective comparative study of two late-generation intramedullary techniques (the AO proximal femoral nail [PFN] versus the Gamma nail) in the surgical management of unstable intertrochanteric fractures. Materials and methods. In a study of 156 patients, the AO PFN was implanted in 79 and the Gamma nail in 77 patients with AO fractures type 3-1-A2 and type 3-1-A3. The mean age of patients was 82.3 years in the PFN group and 81.8 years in the Gamma group. Operating times, imaging, transfusion requirements, medical and mechanical complications, and clinical outcome after one year of follow-up were analyzed. Results. No significant differences were observed in the general characteristics of the two groups. Patients treated with a Gamma nail received more transfusions and had more frequent and more intense pain in the thigh. No significant differences were observed in the mechanical complications or functional results at one year. Conclusions. The performance of the two implants was similar, both producing excellent results in the stabilization of unstable intertrochanteric fractures and few mechanical complications; patients implanted the Gamma nail had significantly more frequent transfusions and pain in the thigh.