Proximal Femoral Nail Antirotation versus Gamma3 nail for intramedullary nailing of unstable trochanteric fractures. A randomised comparative study.

Abstract

The purpose of this study was to compare the clinical results and the complication rates of a new generation of two intramedullary fixation devices: Proximal Femoral Nail Antirotation® (PFNA) and Gamma3®. We conducted a prospective randomised multicentre trial of 61 patients who underwent a PFNA fixation treatment (31 patients) or a Gamma3 nail (30 patients). We documented the fixation failure complications as well as data of the surgical procedure, the clinical and functional outcomes (the EuroQoL5 questionnaire, the Katz index score, the Short Form 36 (SF-36), and the Harris Hip Score) and the plain radiographic parameters at 3,6 and 12 months follow up. The PFNA and Gamma3 fixation devices were similar in terms of complication rates. The risk for experiencing a postoperative complication after Gamma3 nailing was 40% versus 45% after PFNA fixation. At the 6-month and 1-year follow-up evaluations, there were no significant differences in terms of range of motion, clinical scores and radiological outcomes.