الفهرس | Only 14 pages are availabe for public view |
Abstract Inter-trochanteric femoral fractures occur between the greater and lesser trochanters and are commonly observed in the elderly it is one of the most important causes of mortality and morbidity in the geriatric population.(4) The incidence of trochanteric fractures has increased significantly during the last few decades becoming important in terms of social and economic issue.(2) Currently, internal fixation devices for treating unstable inter-trochanteric femoral fractures are classified into extra-medullary and intra-medullary fixation devices, both of which show advantage and disadvantages.(13) Extra-medullary fixation, as the dynamic hip screw (DHS) method, has always been universally accepted as the ”gold standard” for treating intertrochanteric femoral fractures. However, DHS method has a relatively high failure rate in treating unstable intertrochanteric femoral fracture.(75) The gamma nail is a classic intramedullary fixation device for treatment intertrochanteric fractures that was developed by combining the sliding hip screw and intramedullary nail system.(77) Primary nail is placed in the intra medullary cavity, creating central fixation. Several advantages of the gamma nail have been proposed, such as its application to the femoral head and neck and femoral shaft to increase stability at fracture sites and to promote healing.(77) In addition, its fixed application through the medullary cavity allows for early functional exercise and full weight-bearing of the affected limb. The standardized surgical technique for implementing gamma nails is accessible for surgeons, and the duration of operation is short, resulting in small operative wounds. However, it is unsuitable for patients with occlusive medullary cavities, very large anterior arches in femur shafts, and those with the risk of fat embolism. The complications of the gamma nail include aggravated intertrochanteric fractures and stress fractures of the distal femoral shaft during the insertion of the main nail.(77) The aim of this study was to evaluate the results of management of unstable intertrochanteric femoral fractures by gamma nails. This prospective study was done among 20 patients diagnosed as unstable intertrochanteric fractures of the femur (Kyle type III & IV and Boyd & Griffin type II & III), treated with caphalo-medullary nails. The study was conducted at El-Menofia University hospital and Luxor General Hospital. |