Intertrochanteric fracture non-unions with implant failure of the gamma nail

Sbiyaa, Mouhcine; Alaoui, Adil; M, Admi; Lahrach, K.; Marzouki, A.; Boutayeb, F.

doi:10.11604/pamj.2016.23.57.7965

Cited by 5 publications

(9 citation statements)

References 19 publications

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“…Strict monitoring is required to prevent implant loosening or breakage, which usually occurs at the level of the cervical screw regarded as a zone of weakness. 27 In our series we observed 02(0.5%) cases of pseudarthrosis including a case complicated with implant breakage. In recent literature, multicenter studies have reported incidence of Gamma implant failure from 0% to 0.4%.…”

Section: Discussionmentioning

confidence: 57%

Implanted related complications and mortality after gamma nail fsor unstable trochanteric fractures: (a report of 450 consecutive cases)

Niandou¹,

Lahrach²,

Marzouki³

et al. 2019

MOJOR

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The Gamma nail represents the latest advancement in the treatment of trochanteric fractures combining the principles of intramedullary nailing with almost percutaneous insertion. Despite its mechanical advantages, the gamma nail is not immune to complications like other methods for surgical management of extracapsular hip fractures in the elderly. The objective of this paper is to assess the outcome of surgical treatment of trochanteric fractures using Gamma nails with focus on its potential per and postoperative complications through a retrospective series of 450 patients managed at the department of Trauma and Orthopedic Surgery A,

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Section: Discussionmentioning

confidence: 57%

Implanted related complications and mortality after gamma nail fsor unstable trochanteric fractures: (a report of 450 consecutive cases)

Niandou¹,

Lahrach²,

Marzouki³

et al. 2019

MOJOR

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“…Most trochanteric fractures of the femur occur in elderly patients and require adequate treatment as soon as possible. Proximal femoral intramedullary nails—particularly PFNA and Gamma 3—are the most common choice during surgical treatment, however complications (e.g., cut through and cut-out) have been reported 1 2 3) . Therefore, gamma 3 nails with a U-blade lag screw are used for unstable fractures and high risk patients, but there are no comprehensive studies reporting postoperative outcomes 4) .…”

Section: Discussionmentioning

confidence: 99%

“…Trochanteric fractures can fail because of inappropriate axial load of body weight, the relative strengths of hip flexors and external rotators or displacement of fracture fragments. Fixation failure (e.g., metal breakage and nonunion after surgery) are most commonly the result of varus fixation, excessive weight bearing, and stress fracture caused by poor nutrition during recovery 1 7 8 9) . Gamma-3 nails are known to have a postoperative fracture rate of 2.0% to 5.7%, in part because of their structural design and material durability.…”

Section: Discussionmentioning

confidence: 99%

“…Gamma-3 nails are known to have a postoperative fracture rate of 2.0% to 5.7%, in part because of their structural design and material durability. Most postoperative fractures are stress fractures occurring between 6 months and 10 months 1 8 10) . When fixation failures occur because of metal breakage, additional internal fixation (e.g., replacement of lag screw or nail with a long intramedullary nail, arthroplasty after removal of the broken nail) is necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Trochanteric fractures account for 10% to 34% of total hip fractures and most occur in elderly patients 1 2) . Proximal femur intramedullary nails are frequently used for reduction of trochanteric fractures.…”

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confidence: 99%

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Failure of a Rotation Control Gamma 3 Lag Screw Used to Treat a Trochanteric Fracture

et al. 2018

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Gamma 3 rotation control lag screws (U-blade) are particularly useful when treating rotational and unstable fractures of the proximal femur. A 93-year-old woman who underwent closed reduction of a trochanteric fracture and internal fixation with a Gamma 3 nail rotation control lag screw. The patient presented with metal failure and U-blade bending following a fall occurring 4 weeks after surgery. Here, we present a case report summarizing removal of the failed lag screw.

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Case report: unique failure of a Synthes TFNA fenestrated lag screw in a peritrochanteric nonunion

Smidt

Perry

Andre

et al. 2022

OTA International: The Open Access Journal of Orthopaedic Trauma

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Background: Intertrochanteric femur fractures are a common orthopaedic injury that are often treated surgically. Cephalomedullary nails (CMN) are frequently the implant of choice for intertrochanteric femur fractures, resulting in low complication rates. Implant failure is a rare but reported complication. Common locations of failure include the proximal nail aperture, distal screw holes, and implant shaft. In this case report, we describe a CMN failure pattern through fenestrated cephalic screw holes.Case: A 70-year-old female sustained an OTA 31A-2.2 peritrochanteric fracture during a motor vehicle collision. She was treated the following day with a Synthes Trochanteric Fixation Nail-Advanced CMN utilizing a fenestrated cephalic screw. There were no intraoperative complications. She was made non-weight bearing for 8 weeks after the procedure due to ipsilateral foot fractures. At 6 months follow-up she was noted to have a delayed union. 11 months postoperatively she suffered a ground level fall and the cephalic lag screw failed through its fenestrations, resulting in varus collapse of her fracture at the femoral neck. The patient then underwent nail extraction and salvage total hip arthroplasty. Conclusion:Cephalomedullary nail implant failure is presented with implant fracture propagation through a fenestrated cephalic screw. Cephalomedullary lag screw failure is rare and can be difficult to manage. It is important to monitor new implants for unique failure mechanisms.

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Intertrochanteric fracture non-unions with implant failure of the gamma nail

Cited by 5 publications

References 19 publications

Implanted related complications and mortality after gamma nail fsor unstable trochanteric fractures: (a report of 450 consecutive cases)

Implanted related complications and mortality after gamma nail fsor unstable trochanteric fractures: (a report of 450 consecutive cases)

Failure of a Rotation Control Gamma 3 Lag Screw Used to Treat a Trochanteric Fracture

Case report: unique failure of a Synthes TFNA fenestrated lag screw in a peritrochanteric nonunion

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