More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures

Eivind Kaare Osnes 1Oslo Orthopaedic University Clinic, Ulleval Hospital, NO-0407 Oslo, Norway. E-mail: [email protected]; 2Dept. of Medicine, Aker University Hospital, Oslo, Norway, 3National Health Screening Service, Oslo, Norway, 4National Board of Health, Oslo, Norway, 5Institute of Public Health-Health Economics, University of Southern Denmark, Odense, Denmark. Correspondence: Professor Lars Nordsletten

Cathrine M Lofthus 1Oslo Orthopaedic University Clinic, Ulleval Hospital, NO-0407 Oslo, Norway. E-mail: [email protected]; 2Dept. of Medicine, Aker University Hospital, Oslo, Norway, 3National Health Screening Service, Oslo, Norway, 4National Board of Health, Oslo, Norway, 5Institute of Public Health-Health Economics, University of Southern Denmark, Odense, Denmark. Correspondence: Professor Lars Nordsletten

Jan A Falch 1Oslo Orthopaedic University Clinic, Ulleval Hospital, NO-0407 Oslo, Norway. E-mail: [email protected]; 2Dept. of Medicine, Aker University Hospital, Oslo, Norway, 3National Health Screening Service, Oslo, Norway, 4National Board of Health, Oslo, Norway, 5Institute of Public Health-Health Economics, University of Southern Denmark, Odense, Denmark. Correspondence: Professor Lars Nordsletten

Haakon E Meyer 1Oslo Orthopaedic University Clinic, Ulleval Hospital, NO-0407 Oslo, Norway. E-mail: [email protected]; 2Dept. of Medicine, Aker University Hospital, Oslo, Norway, 3National Health Screening Service, Oslo, Norway, 4National Board of Health, Oslo, Norway, 5Institute of Public Health-Health Economics, University of Southern Denmark, Odense, Denmark. Correspondence: Professor Lars Nordsletten

Inger Stensvold 1Oslo Orthopaedic University Clinic, Ulleval Hospital, NO-0407 Oslo, Norway. E-mail: [email protected]; 2Dept. of Medicine, Aker University Hospital, Oslo, Norway, 3National Health Screening Service, Oslo, Norway, 4National Board of Health, Oslo, Norway, 5Institute of Public Health-Health Economics, University of Southern Denmark, Odense, Denmark. Correspondence: Professor Lars Nordsletten

Ivar S Kristiansen 1Oslo Orthopaedic University Clinic, Ulleval Hospital, NO-0407 Oslo, Norway. E-mail: [email protected]; 2Dept. of Medicine, Aker University Hospital, Oslo, Norway, 3National Health Screening Service, Oslo, Norway, 4National Board of Health, Oslo, Norway, 5Institute of Public Health-Health Economics, University of Southern Denmark, Odense, Denmark. Correspondence: Professor Lars Nordsletten

Lars Nordsletten 1Oslo Orthopaedic University Clinic, Ulleval Hospital, NO-0407 Oslo, Norway. E-mail: [email protected]; 2Dept. of Medicine, Aker University Hospital, Oslo, Norway, 3National Health Screening Service, Oslo, Norway, 4National Board of Health, Oslo, Norway, 5Institute of Public Health-Health Economics, University of Southern Denmark, Odense, Denmark. Correspondence: Professor Lars Nordsletten

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Abstract

Despite several studies showing a higher incidence of peri-implant femoral fractures with the Gamma nail than with a sliding screw plate (SSP), the Gamma nail has remained the standard implant for trochanteric fractures in many hospitals. We recorded 921 trochanteric fractures in the city of Oslo during 2 years and compared the reoperation frequency in patients treated with the Gamma nail (n 379) and SSP (n 542). The distribution of age and gender in the two treatment groups was the same. 65 patients were reoperated on, several of them more than once. The only significant difference between the two surgical methods in complications leading to a reoperation was the frequency of femoral shaft fractures. 17 of the patients treated with the Gamma nail had a new femoral fracture postoperatively, compared to 3 of those with a SSP. The relative risk of another femoral fracture after surgery was 12 (95% CI: 2.7-52) if the surgical device was a Gamma nail compared to a SSP.The Gamma nail therefore can not be recommended as the standard implant for trochanteric fractures.

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More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures

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More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures

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