Use of the Gamma nail in the treatment of fractures of the proximal femur.

Fractures of the proximal femur are, more than ever, an important challenge in the field of traumatology. The Gamma nail, a combination of advantages of the sliding screw with the intramedullary nail, represents an efficient technique in the management of these fractures. A series of 224 fractures of the proximal femur in which this nail was used is reported. The average age of the patients was 79.2 years. The mean healing time was 68.2 days in 99.4% of the cases. The incidence of perioperative complications was 10.3% showing that, in most of the cases, the complications occurred because of poor technique. Postoperative complications occurred with an incidence of 14.1%. Seven cases of migration of a proximal screw, six shaft fractures, and one broken nail were the most important complications. The device allowed for early mobilization and full weightbearing of the affected hip regardless of the type of fracture. With adequate surgical technique and experience, the advantages of the Gamma nail increases as the complication rate diminishes.