The patients for the study will be randomly divided in two groups. Group A: Gamma3 nail (Stryker) and Group B: InterTan (IT) nail (Smith & Nephew). The surgery will take place in one specific operating room with the standardized surgical technique, using the same c-arm for the intra-operative radiological evaluation. Anatomical reduction of the fracture will be intended in all cases prior to nail insertion. If this is not possible, several techniques of closed or open reduction will be applied in order to achieve an acceptable fixation of the fracture. The patients’ position will be on the traction table, using a minimal approach. The lag screw(s) in both groups will be put in the center of the femoral head in the lateral and anteroposterior X-ray view, while the Tip to Apex Distance (TAD) will be approximately 20 mm. All participants in both groups will receive the same physical therapy and adequate anti-osteoporotic treatment.
Gamma 3 nail
Manufactured by Stryker
Sourced in United States
The Gamma 3 nail is a surgical implant used in the treatment of certain types of femur fractures. It serves as a stabilizing device to facilitate the healing process. The Gamma 3 nail is designed to be inserted into the intramedullary canal of the femur.
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Lab products found in correlation
4 protocols using gamma 3 nail
1
Gamma3 vs InterTan Nail in Femur Fractures
2
Proximal Femur Fractures: Surgical Interventions
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Twenty-two patients (n = 22) undergoing surgery because of proximal femur fracture and an average age of 81 ± 8 years were analyzed. 50% were male or female; the average ASA score was 2.5 ± 0.6. 59% of the patients, suffering from an intertrochanteric fracture, were treated by an osteosynthesis using a Gamma3® nail (nGN = 8, Stryker, Kalamazoo, MI, USA) or a Dynamic hip screw (nDHS = 3, DePuy Synthes Companies, Zuchwil, Switzerland). In displaced femoral neck fractures, a bipolar hemiarthroplasty or a total hip (nHA = 9, CORAIL®, DePuy Synthes Trauma, West Chester, PA, USA) was implanted. Nondisplaced femoral neck fractures were stabilized using 8 mm cannulated Olmed screws (nOS = 2, Biomet, Warsaw, IN, USA) as previously described [14 (link)]. All operations allowed full weight bearing. Indications and operations followed the local standard operating procedures. The average BMI was 25.9 ± 5.4; 64% of the participants were in need of mobility aids before their fall.
3
Surgical Management of Femoral Fractures
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All patients were treated surgically with a femoral nail, using the institutional standard implant a Gamma 3 nail (Stryker). The standard approach in our institute is a closed reduction under radiological control and internal fixation (CRIF) with the patient in a supine position on a traction table. If the reduction is inadequate in either the anterior–posterior or the lateral view, the treating surgeon decides for open reduction and internal fixation (ORIF). In both cases, the entry point for the intramedullary implant is the tip of the trochanter. In cases where sufficient reduction cannot be maintained, cerclage wires (cable cerclage, 1.6 mm in diameter) may be used at the discretion of the treating surgeon. Postoperative rehabilitation includes full weight bearing, daily physiotherapeutic training, and optimized medical treatment. The follow-up appointments were performed after 6 weeks, 12 weeks, 6 months and 12 months. Radiographic imaging to assess the state of fracture healing was obtained at each appointment, focusing on persistent fracture lines, insufficient bone bridging, progressive deformity and the presence/absence of broken implants.
4
Femoral Intertrochanteric Fracture Management
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The inclusion criteria were patients who received CM nailing at Seoul Medical Center (Seoul, Korea) due to femoral intertrochanteric fractures from April 2011 to March 2014, with a minimum follow-up of six months (an average of 11.5 months). The exclusion criterion was those who died during the postoperative period before discharge. A total of 134 patients underwent surgery. Of these, 129 patients were enrolled in the study, excluding five patients who died prior to discharge or were followed up for less than six months.
The surgical devices used were Gamma 3 nail (Stryker, Mahwah, NJ, USA) in 94 cases and intertrochanteric/subtrochanteric nail (ITST nail; Zimmer, Winterthur, Switzerland) in 35 cases, and short nails were used in all 129 patients. The AO/OTA classification was used in preoperative assessment to classify the fractures (Table 1 ). The shape of the medullary canal was grouped based on the Dorr classification. The patients were classified as 6 Dorr type A (4.7%), and 103 Dorr type B (79.8%) and 20 Dorr type C (15.5%)12) (link). The American Society of Anesthesiologist (ASA) classification system was used to assess the fitness of patients, and five patients were graded as ASA grade 1, 85 as grade 2, 36 as grade 3, and three as grade 46 (link)13 (link)14) (link).
The surgical devices used were Gamma 3 nail (Stryker, Mahwah, NJ, USA) in 94 cases and intertrochanteric/subtrochanteric nail (ITST nail; Zimmer, Winterthur, Switzerland) in 35 cases, and short nails were used in all 129 patients. The AO/OTA classification was used in preoperative assessment to classify the fractures (
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