Müller reported that 78% of Ender nail fixation cases did not require transfusion. Bony union was achieved in 24 from the 26 cases (92.3%) in PFN series when compared with 20 out 24 cases (83.33%) in DHS series. Besides, percutaneous compression plate (PCCP) gives results which are better or similar to those obtained with DHS. Results showed that the Gamma nail had a significantly increased risk of fracture of the femoral shaft and an increased reoperation rate. Dynamic hip screws and Gamma nails were inserted by using the previously presented standard techniques in line with the recommendations of the manufacturers of the Gamma nail (Howmedica Ltd., London, UK) and the DHS implant (Stratec Medical, Oberdorf, Switzerland). A meta-analysis has been carried out of all published randomised trials which compare the gamma with the DHS nail, giving in a total of 1794 patients with extracapsular femoral fractures. 3,14 There was no mortality six months after fixation with gamma nail in the present study while Leung reported significant mortality in both his gamma nail and DHS group. Dynamic hip screw vs. proximal femur nail in treatment of intertrochanteric fractures in patients aged over 70 years old. BACKGROUND Intertrochanteric fracture is one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to low-energy trauma like simple falls. Several studies comparing the Gamma nail and DHS have shown DHS to be a better method in the treatment of trochanteric fractures [4, 23, 24], and some studies have failed to establish any significant differences between these two methods [9, 19, 25], whereas one study concluded that GN was more effective than the DHS . the Gamma nail did not perform as well as DHS because it led to a relatively higher incidence of post-operative femo-ral shaft fracture [5,6]. The Gamma nail group had significantly higher Barthel Index and EuroQol-5D (EQ-5D) scores than the AMBI group at 12 months. Subscribe for more lectures https://www.youtube.com/user/OrthopaedicPrinciple PFN, introduced by the AO/ASIF group in 1997, has become prevalent in treatment of intertrochanteric fractures in recent years because it was improved by addition of an antirotation hip screw proximal to the main lag screw. Summary. The proximal end of the nail accepts two cephalocervical screws: a larger superior 11 mm lag screw and a small- er inferior 7 mm compression screw. The study also endeavors to suggest modifications in the Gamma nail technique to prevent commonly mentioned complications. The diameter of proximal end is 16.25×15.25 mm and distal end is 10 mm. There are several surgical methods to treat intertrochanteric fracture: dynamic hip screw (DHS), compression hip screw (CHS), percutaneous compression plate (PCCP), Medoff sliding plate, less invasive stabilization system (LISS), Gamma nail, proximal femoral nail (PFN), and proximal femoral nail anti-rotating (PFNA). Objective To evaluate and compare the clinical and radiological outcomes of patients with stable intertrochanteric fractures treated with proximal femoral nail (PFN) vs. dynamic hip screw (DHS). Type II anodization for titanium implants offers increased fatigue strength 1. Purpose: Nowadays, the literature shows better results in the treatment of intertrochanteric (AO/OTA 31.A1-A2) hip fractures with dynamic hip screw (DHS) compared with gamma nail (GN). DHS, also called the Richard nail, is a plate extramedullary fixation system and was first used in clinical practice in 1967; ... Fourthly, the design of the gamma nail is hollow, and a small incision is needed to place a guide pin into the marrow cavity. However, PFNA, the latest developed device, is considered as a perfect device for intertrochanteric fracture with a lower incidence of complications [9, 10]. Five trials (623 participants) compared the intramedullary hip screw (IMHS) with the SHS. In 119 cases of Ender nailing, there were 10 cases with more than 10° varus (10%) and five cases of malunion with more than 10° external rotation (4.2%). Dynamic Hip Screw (DHS) is still considered the gold standard for treating intertrochanteric fractures by many. Sixty patients with unstable Intertrochanteric fractures will be randomized to be treated using either Gamma nail or DHS. Background . DHS and Gamma nail were most commonly used for fixing intertrochanteric fractures in the last decade [29 ]. | Sort by Date Showing results 1 to 4. Gamma is a comprehensive intramedullary nailing system for the treatment of a wide range of proximal femur fractures as well as associated femoral shaft fractures. 69.33% from the cases had great results in PFN series when compared with 70.8% in DHS series. Shanghai Med J. MATERIALS & METHODS: Perioperative blood loss was evaluated in 417 consecutive patients treated for trochanteric fracture with DHS or Gamma nail between January 2010 and March 2013. Orthopaedics & Traumatology: Surgery & Research - Vol. There was no difference in failure of proximal fixation: cut-out occurred in three cases with the DHS, and twice with the Gamma nail. device vs fixed-angle Furthermore, the percutaneous inser- screw-plate;15 SHS, Gamma nail, PFN;16 SHS vs short tion of the IM device may reduce the trochanteric nail23 amount of surgical trauma. Methods . PLATE IN THE TREATMENT OF UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURE. Previous studies showed that the Gamma nail did not perform as well as DHS because it led to a relatively higher incidence of post-operative femoral shaft fracture [5,6]. Intertan nail applied in this study is a solid tita-nium nail of 182 mm in length with a trapezoi-dal proximal end, whose neck angle is 125°. Gamma nail vs. dynamic hip screw in 120 patients over 60 years — A randomized trial @article{Kukla2007GammaNV, title={Gamma nail vs. dynamic hip screw in 120 patients over 60 years — A randomized trial}, author={C. Kukla and T. Heinz and G. Berger and O. Kwasny and A. Rosenberger and V. V{\'e}csei}, journal={Acta Chirurgica Austriaca}, year={2007}, volume={29}, pages={290-293} } C. … There were no major differences between implants in wound infection, mortality or medical complications. The aim of this prospective matched-pair (age, sex, fracture type, residential status, and walking ability at fracture) study was to analyse the short-term outcome after Gamma nail (GN) and dynamic hip screw (DHS) fixation, focusing especially on functional aspects (Standardised Audit of Hip Fractures in Europe [SAHFE] hip fracture follow-up forms), reoperations, and mortality. Nuber S, Schönweiss T, Rüter A. Stabilisation of x hip screw (DHS) with trochanteric stabilisation plate vs. proximal femur nail (PFN) Unfallchirurg. The purpose of this meta-analysis was to find out whether the proximal femoral nail was better than the dynamic hip screw in the treatment of trochanteric fractures with respect to operation time, blood transfusion, hospital stay, wound complications, number of reoperation, and mortality rate. This is a prospective study. PFN, introduced by the AO/ASIF group in 1997, has become prevalent in treatment of intertrochanteric fractures in recent years because it was improved by addition of an antirotation hip screw proximal to the main lag screw. The goal of this study is to compare the clinical and radiographical results of Dynamic hip screw (DHS) and Proximal femoral nail (PFN) for the treatment of trochanteric hip fractures. Dynamic hip screw (DHS) and Gamma nail were commonly used but often associated with some complications, such as fixation failure and implant-related fractures. But only two reports compare the results between PCCP and GN. There was significantly less blood loss in patients receiving a Gamma nail (148 mL) relative to the DHS (522 mL) and fewer units transfused (0.95 vs. 1.82) in Penot's retrospective study .
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