Aim: We have performed a retrospective comparative study between the trochanteric gamma nail (TGN) and the proximal femoral nail (PFN).
Method: During the period 1998-2003, 97 TGN and 83 PFN were used for the treatment of pertrochanteric fractures. Most of the fractures were of the A3 type according to the AO/ASIF classification. Clinical and radiological follow-ups were available for 87 TGN and 65 PFN.
Results: The mean operative time for the TGN was shorter than that for the PFN. Intraoperative complications were noted in 17.5 % and 28.8 % for the TGN and PFN groups, respectively. Late complications occurred in 18.4 % for TGN compared to 27.6 % of the PFN. Union was achieved in 94.2 % and 89.3 % of the patients treated with the TGN and PFN, respectively. The reoperation rates were 10.3 % and 24.6 % for the TGN and the PFN, respectively. Clinical outcomes were good for both groups (65 % in the TGN, 62 % in the PFN group).
Conclusion: Treatment of pertrochanteric fractures using the TGN and PFN implants is quite reliable. The major complication was cut-out and occurred mostly in the PFN group, while varus deformity was more frequent in the TGN group. The PFN was associated with a higher rate of reoperation and longer operative time, probably due to a more demanding technique.