Peter Z. Cohen, MD
Approximately 300,000 hip fractures occur annually in the United States, a problem which amassed a health-care cost of more than $8 billion in 1987. With little change, the gold standard of treatment for much of this decade has been compression plate/lag screw fixation. Important advancements afforded by intermedullary interlocking nail technology has brought forth an important new advancement in proximal hip fracture management.
Developed by Dr. Aaron Gross of Strasbourg, France, the Gamma Nail is a new internal fixation device for the treatment of proximal femoral fractures. This device is suitable for fracture management of the intertrochanteric, pretrochanteric, and subtrochanteric areas. This applies to stable or unstable types, and in traumatic and pathologic fractures.
Operative treatment for trochanteric fractures in elderly patient can be a challenging problem. The primary goal of the orthopaedic surgeon is to stabilize the fracture so as to permit early mobilization of the patient in hopes of lessening the morbidity and mortality statistics associated with these maladies. Furthermore, in order to prevent the social consequences of loss of ambulatory status, the goal is to return the patient to his prefracture function as quickly as is possible, which also addresses the economic burden that hip fractures place on our society.
The Gamma Nail combines the features of intramedullary nailing with the compression lag screw and adds the capability of distal locking. It's design and biomechanical principles achieve greater strength and stability for load-sharing and physiologic stress. The nailing is accomplished in a closed manner which should decrease anesthesia time, surgical time, length of exposure and blood loss. Earlier weight bearing, mobilization and healing can therefore be achieved.
One of the first orthopaedic surgeons in the United States to employ the use of the Gamma Nail is Dr. Peter Cohen, Chief of Orthopedics at Pittsburgh's Montefiore University Hospital. Dr. Cohen recently reviewed this new development and surgically demonstrated its application for the VJO. Dr. Cohen states, "We believe that the Gamma Nail is an excellent, if not a better, surgical option over the more traditional methods of hip fracture treatment. This is especially true in unstable pretrochanteric and subtrochanteric varieties."
- Williams JJ, Cohen PZ Early Results of Treating Intertrochanteric and Subtrochanteric Hip Fractures with the Gamma Nail Pitt Orth J 1:21-23; 1990
- Total Run Time: 17:08 minutes
- Catalog Number: 4015
- VJO Publication Date: April, 1991