Operative Technical Errors and Complications in Use of Gamma Nail

Abstract

The aim of this investigation was to figure out the sources of technical errors during the operation and the complications that may occur in the later course of treatment. Over the last three years, 136 patients were treated with the Gamma nail, 91 Trochanteric Gamma nails, 17 Standard Gamma nails and 28 Long Gamma nails. After an evaluation of clinical and radiographic data, we observed numerous intraoperative errors as follows: inadequate reduction of the fracture, incorrect entry point, malpositioned lag screw guide wire, incorrect choice of material, lag screw and distal screw problems. The complications noted postoperatively were: “cut out”, malunion, trochanteric and thigh pain, and distal screw failure. The technical errors mentioned above did not lead to failure of the osteosynthesis in the majority of the patients. In a small group, mobilization and weight bearing were delayed, in order not to jeopardize the treatment, or a revision procedure took place. In most of the cases, complications occurred because of poor technique and lack of experience. With adequate surgical technique and experience, the advantages of the Gamma nail increase as the complication rate diminishes.

Key words

Peritrochanteric - intramedullary - lag screw - distal locking

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