Boriani S, Bettelli G, Zmerly H, Specchia L, Bungaro P, Montanari G, Capelli A, Canella P, Regnoli R, Rispoli R
Rizzoli Inst, Bologna, Italy.
Orthopedics. 1991 Dec;14(12):1307-14. doi: 10.3928/0147-7447-19911201-05.
In a multicentric study, the data of 628 trochanteric fractures, two non-unions, and 18 pathologic or impending fractures treated by Gamma nail in 13 Italian traumatology services were collected and analyzed. In 70% of the patients weight bearing was allowed in the first postoperative week and 78% of the controlled patients returned to their pretrauma walking ability. Complications included intraoperative (1.4%) and postoperative (1.2%) shaft fractures, "cut out" of the lag screw (2.6%), and nail failure (0.5%). There were no cases of infection. An analysis of complications showed that most of them were due to technical mistakes. The safest procedure is 2 mm diaphyseal overreaming, introduction of the nail without hammering, and distal locking; the lag screw should be placed in the lower part of the head of the femur.
在一项多中心研究中，收集并分析了意大利13个创伤科使用Gamma钉治疗的628例转子间骨折、2例骨不连以及18例病理性骨折或疑似骨折的数据。70%的患者在术后第一周即可负重，78%的对照患者恢复到创伤前的行走能力。并发症包括术中（1.4%）和术后（1.2%）股骨干骨折、拉力螺钉“穿出”（2.6%）以及髓内钉失效（0.5%）。无感染病例。对并发症的分析表明，大多数并发症是由技术失误导致的。最安全的操作方法是骨干扩髓2mm，不使用锤击法插入髓内钉并进行远端锁定；拉力螺钉应置于股骨头下部。
