Abstract 【Objective】To explore clinical efficacy for the treatment of unstable femoral intertrochanteric fracture with lateral wall risky by Gamma3 intramedullary nail and analyze the clinical effect of comminuted medial cortex. 【Methods】The clinical data of 56 patients with lateral wall risk femoral intertrochanteric fractures treated by Gamma3 intramedullary nail from September 2018 to March 2021were retrospectively analyzed. The quality of fracture reduction, fracture healing, internal fixation position, TAD, CalTAD, the neck shaft angle (NSA) and femoral neck long axis (FNLA) were observed. Baumgaertner criteria were used to evaluate quality of fracture reduction,Harris criteria were used to evaluate hip joint function.【Results】The fracture healing time was 9-15 weeks with average of 11.7 weeks. According to Baumgaertner criteria, 27 cases obtained good results,13 cases were acceptable,and 3 poor healing. The good and acceptable rate was 93%. The neck shaft angle was 122°-147° without hip varus (mean, 132°). The average of TAD was 22.3mm and the average of CalTAD was 23.2mm. The excellent and good rate of Harris score was 88.4％. In the cases with comminuted medial cortex, the NSA(124.4±4.8)°was significantly less than that in the group without comminuted medial cortex(132.8±5.8)°, P<0.05. The FNLA(81.1±4.4)mm in the comminuted medial cortex group was significantly shorter than that in the group without comminuted medial cortex(89.2±5.7)mm, P<0.05. And its Harris hip score(80.8±6.4) was significantly lower than that in the group without comminuted medial cortex(89.8±5.6, P<0.05). 【Conclusion】 In the treatment of femoral intertrochanteric fractures with lateral wall risky, Gamma3 intramedullary nail can achieve an excellent clinical outcome. Along with comminuted medial cortex, the presence of lateral wall result in relatively poor stability of internal fixation and decrease hip function.
LI Cheng,HAN Li-gang,WANG Bing-xin, et al. Curative Effect Analysis of Gamma3 Intramedullary Nail for the Treatment of Unstable Femoral Intertrochanteric Fractures with Lateral Wall Risky[J]. JOURNAL OF CLINICAL RESEARCH, 2022, 39(4): 557-560.
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2022, Vol. 39 
