Herrera A, Domingo L J, Calvo A, Martínez A, Cuenca J
Orthopaedic Surgery and Traumatology Service, Miguel Servet University Hospital, Avda, Isabel la Catolica 1-3, 50009, Zaragoza, Spain.
Int Orthop. 2002;26(6):365-9. doi: 10.1007/s00264-002-0389-6. Epub 2002 Jul 31.
The aim of the present paper is to compare the results obtained using two osteosynthesis systems developed for the surgical treatment of fractures of the trochanteric region of the femur, based on the principles of closed intramedullary nailing: the Gamma nail and the proximal femoral nail (PFN). A prospective study is presented of 125 trochanteric fractures of the femur treated with PFN and 125 treated with the Gamma nail in our service between the years 1997 and 2000, with the prerequisite of a minimum follow-up of 1 year. Fractures were classified according to the AO system, the most commonly recorded subtype encountered being the A2. Clinical and radiographic controls were performed upon admission and in the post-operative follow-up at 1, 3, 6, and 12 months, the corresponding assessment protocol being completed on each occasion. Of the 250 patients, 179 were women and the rest men. The average age was 78.9 years. Both systems enabled early mobilisation and walking in most of our patients. There were no significant differences in the use of either nail in terms of the recovery of previous functional capacity, nor in terms of the time required for fracture healing (12 weeks on average). With regard to the more significant technical complications recorded, shaft fractures and the cutting-out phenomenon were more common with the use of the Gamma nail, while secondary varus occurred at a greater rate when using the PFN.
伽马钉和股骨近端髓内钉（PFN）。本文呈现了一项前瞻性研究，1997年至2000年间，我们科室对125例使用PFN治疗的股骨转子骨折和125例使用伽马钉治疗的股骨转子骨折进行了研究，前提是至少随访1年。骨折根据AO系统进行分类，最常见的记录亚型为A2。入院时以及术后1、3、6和12个月的随访中进行临床和影像学检查，每次均完成相应的评估方案。250例患者中，179例为女性，其余为男性。平均年龄为78.9岁。两种系统都能使我们的大多数患者早期活动和行走。在恢复先前功能能力方面，两种钉子的使用情况没有显著差异，骨折愈合所需时间（平均12周）也没有显著差异。关于记录到的更严重的技术并发症，使用伽马钉时骨干骨折和切割现象更常见，而使用PFN时继发内翻发生率更高。
