Use of the long gamma nail in fractures of the persubtrochanteric region. Retrospective study

A retrospective study was made of patients with fracture of the subtrochanteric area, treated with the Gamma long nail between 1992 and 1998. A review was made of 31 patients, 14 men and 17 women, mean age 73 years; 26 patients had fractures, 4 had complications of earlier treatments, and one was a prophylactic procedure for a lytic lesion of tumoral origin. According to the AO fracture classification and Singh osteoporosis index, there were 7 cases of 31A2 fracture, 14 cases of 31A3, 3 cases of 32A1, 14 cases of 31A1, and 2 cases of 32B1. Blood loss, mechanical complications, and the functional result were evaluated. The mean follow-up of the 26 fractures was 13 months. Mechanical complications appeared in 19.3% of patients, but only 6.4% had clinical repercussions. Blood transfusion was required in 43.7%. Fracture consolidation was achieved in every case within a mean time of 3 months. All patients recovered their previous walking status. Intrahospital mortality was 6% and the 3-month mortality was 12.9%. In view of the percentage of successful consolidations, functional recovery, and number of complications, the long Gamma nail was suitable for treating subtrochanteric fractures.