A unique cause of Gamma 3 cut-out: A case report and literature review

Abstract

Gamma 3 nail is a wide spread intramedullary device for fixation of per trochanteric fractures. Cut out of the lag screw is the most common complication of this implant. We present a 62-year-old female patient, who underwent a total hip arthroplasty following cut out of a Gamma 3 nail in the femoral neck. The cause of the cut out in our case is actually unique. Our intraoperative findings accompanied with the radiographic evaluation argue that the malposition of the set screw was the cause of failure, due to the rotational instability of femoral head-lag screw unit. We present this case with detailed description, highlighting the proper use of this specific nail and appose a brief literature review.

A new scoring system for predicting cut-out risk in patients with intertrochanteric femur fractures treated with proximal femoral nail anti-rotation

“… 18 - 20 Although the incidence of cut-out after Gamma-3 nailing varies between 1.6% and 4.3% in the literature, 21 - 24 rates can reach up to 12.5%. 11 , 25 However, the incidence of cut-out after PFN-A applications was reported to be 8.2%. 26 All patients in the present study were treated with PFN-A, and the cut-out rate was 7.2% (35 patients).…”