The Long Gamma Nail in the Treatment of 329 Subtrochanteric Fractures with Major Extension into the Femoral Shaft

OBJECTIVE: To study the outcome of treating extensive proximal femoral fractures with the long Gamma nail. DESIGN: Retrospective study, with a minimum follow-up of a year. SETTING: 24 hospitals throughout The Netherlands. SUBJECTS: 329 patients with primary proximal femoral fractures. MAIN OUTCOME MEASURES: Functional results and complications. RESULTS: 19 patients died in hospital and 6 were lost to follow-up. Of the remaining 304 who were fully documented, 241 (80%) became fully mobile, 59 (19%) moderately mobile, and 4 remained bedridden. 264 patients had no pain, 38 had moderate pain and used oral painkillers, and 2 had severe pain that was difficult to treat. Major technical complications occurred in 17 patients: alignment and locking gave rise to most problems, 4 patients developed deep infections, and 7 patients needed additional measures before the fracture was solid. CONCLUSIONS: The long Gamma nail in the treatment of extensive proximal femoral fractures gave good functional results with acceptable rates of complications and union problems.