Treatment of unstable intertrochanteric femoral fractures with locking gamma nail (LGN): A retrospective cohort study

Introduction: Intertrochanteric femoral fractures remain a challenge to orthopedists. Although technologies and instruments have been continuously improved, fixation failure still poses a problem in the treatment of unstable intertrochanteric femoral fractures. The objective of the present study was to evaluate the clinical efficacy of a new type of intramedullary fixing device - locking gamma nail (LGN) - in treating unstable intertrochanteric femoral fractures. Methods: From March 2009 to March 2012, 88 patients with unstable intertrochanteric femoral fractures were treated at our department with LGNs. Twelve patients were excluded from the study. The clinical and radiographic results of the remaining 76 patients were retrospectively analyzed. Results: The mean duration of operation, volume of blood loss, and hospital stay was 50 min, 85 mL, and 8.5 days, respectively. No perioperative complications. Seven patients died 1 year after surgery. The other 69 patients received a mean 23-month follow-up. The mean fracture healing time was 16 weeks. Nine patients felt pain in their hips. Ten patients experienced delayed fracture healing. No other complications. Sixty-one patients had recovered to preoperative levels of function, with a mean Harris hip score of 86.6 and a mean Parker-Palmer mobility score of 7.42. Patients with malreduction were more likely to sustain pain complications (p = 0.002). Older patients were more likely to experience delayed fracture healing (p = 0.045). Conclusions: LGN is a simple and safe treatment for unstable intertrochanteric femoral fractures with satisfactory clinical efficacy and may be considered a new, minimally invasive operative method for treating unstable intertrochanteric femoral fractures. (c) 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.