Results of the long Gamma nail for complex proximal femoral fractures.

The results for a series of 35 patients with complex proximal femoral fractures treated with the long Gamma nail are presented. Fracture healing occurred in all surviving patients, but there were four technical problems associated with the implant. Two nails broke associated with delayed union of the fracture necessitating revision of the implant, one fracture of femur at the site of distal locking occurred during surgery and there was one later fracture at the tip of the nail. All but one failures of fixation were revised with another Gamma nail and healed uneventfully. Overall the number of fracture healing complications compares favourably to contemporary implants and improvements in the design and strength of the nail may further improve results.