[Solution to the problem of extra-articular, femoral hip fracture by the "sliding screw-nail principle". Results of 2 different systems (classical nail and gamma nail)]

Abstract

Between January 1993 and December 1995 we treated 109 patients (median age: 75 years) with 112 extraarticular hip fractures including combined trochanteric and shaft fractures using two different "sliding-screw-nail implants" (intramedullary hip screw = classic nail: n = 61; gamma nail: n = 51). Comparing the two systems in detail certain advantages and disadvantages were seen, with both being equivalent. We encountered the following complications: secondary varus malalignment of the collum femoris with "cut out" of the sliding-screw (1.8%) and without "cut out" (1.8%), fissure of the femoral shaft occurring intraoperatively and being treated conservatively (1.8%), femoral perforation by the nail (0.9%), infection (2.7%). Thus, 5 reoperations (4.5%) were necessary. None of these complications were attributable to the principle itself or to the different implants used. Each patient was followed-up for a minimum of 12 months postoperatively. In 59% of all patients the pre-trauma range of mobility could be fully restored. Intramedullary hip screw and gamma nail are excellent and equivalent systems, which fully satisfy the biomechanical needs of above mentioned fractures.