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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
ORTHOPEDIC AND TRAUMATOLOGIC SURGERY OF THE HIP 98° CONGRESS OF THE PIEDMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPEDICS AND TRAUMATOLOGY (SPLLOT) (Loano, October 19-20, 2001)
Minerva Ortopedica e Traumatologica 2001 June;52(3):135-40
A comparison between Bi-nail and Gamma nail in the osteosynthesis of peritrochanteric fractures. Personal experience in 750 cases
Capelli R., Galmarini V., De Amicis A.
Background. The Authors report their experience over the past 10 years in the treatment of 771 patients with lateral fractures of the femoral neck undergoing Gamma nail (607) and Bi-nail (164) surgery, and 45 patients with per-subtrochanteric fractures treated with the Gamma nail long.
Methods. We evaluated 238 cases (158 Gamma-nail, 57 Bi-nail, 23 Gamma long), including both patients operated in the last three years and patients already controlled in an earlier study published in 1998. The mean follow-up lasted for 18 months.
Results. The results, evaluated using the clinical and radiographic classification proposed by Campanacci were excellent and good in over 90% of patients.
Conclusions. In our experience, blocked intramedullary nailing is the ideal technique for the treatment of lateral fractures of the femoral neck and associated fractures of the femoral diaphysis, especially in elderly patients (the mean age in this series was 81 years), owing to major biological, mechanical and surgical advantages. The method is reliable, fast and minimally invasive. By saving the vascularisation of fragment, blood loss is minimal and there is a low risk of infection. Primary stability is excellent and early loading can also be achieved. Consolidation is rapid, as is functional recovery leading to the patient's reinsertion into normal social life.