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Research ArticleOpen Access

AO/OTA 31-A2 Fractures: Long or Short Gamma Nail?

Volume 1 - Issue 6

R Luque*, B Rizo, C Arvinius, Y Lópiz and F Marco

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    • Orthopaedic Surgery and Traumatology Department, Hospital Clínico San Carlos, Spain

    *Corresponding author: Rafael Luque Pérez, C/Ibiza 15 5º Izqda, Spain

Received: November 10, 2017;   Published: November 16, 2017

DOI: 10.26717/BJSTR.2017.01.000539

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Abstract

Introduction: The Gamma 3 nail is widely used for AO31A1-3 fractures. The aim of this study was to compare outcomes in patients with 31A2 fractures treated with two lengths of Gamma3 nail.

Material: A prospective study of 104 non-pathological 31A2 fractures treated January 2012-January 2014. 14 patients were eliminated due to inadequate follow up. Mean follow-up was 18 months (range 12-36). Average age was 81 years (range 50-99), 78% of the patients were female. We studied two groups: Long Gamma3 Nail (LGN) and Short Gamma3 Nail (SGN). Preoperative variables included: age, medical pathologies, gait, anesthetic risk, associated fractures, hemoglobin and hematocrit values. Postoperatively, we evaluated: functional and radiographic results, quality of life, hemoglobin concentration, hematocrit, transfusion, gait and pain. Intraoperative and postoperative complications were recorded: malunion, nonunion, infection rates, cut-outs and periprosthetic fractures.

Results: We obtained a correct reduction in 73% of cases. We found two intraoperative complications (greater trochanteric fractures) in two LGN cases. 38% of the patients with LGN presented nail tip impaction upon the distal anterior femoral cortex, associated with anterior knee pain. Blood loss was statistically different between groups but neither clinical outcomes nor quality of life presented any differences.

Conclusion: Our results with these two sizes of the Gamma3 Nail in 31A2 fractures showed no overall differences in clinical outcomes and complication rates. Despite this, the LGN presented a statistically significant higher decrease of the postoperative hematocrit and more transfused blood concentrates. We therefore recommend the use of locked SGN to treat the 31A2 fractures.

Keywords: Unstable proximal femur fracture; Unstable pertrochanteric femur fracture; Intramedullary nail; Gamma nail

Abstract| Introduction| Materials and Methods| Results| Discussion| References|