[Complication rate in the treatment of inter- and subtrochanteric femur fractures with two intramedullary osteosyntheses. Comparison of a conventional nailing system and a rotation stable fixation of the head-neck-fragment, gammanail and glidingnail].

Aim of the study was to evaluate typical complications in osteosynthesis of inter- and subtrochanteric femur fractures with intramedullary nailing systems. In the literature screw perforation of the femoral head into the acetabulum, postoperative fracture of the femur shaft, intraoperative shaft fracture, problems in placing of distal locking screws and deep infections are mostly described. In a retrospective study the complication rate of 100 consecutive gammanail osteosyntheses (GAN) and 96 glidingnail osteosyntheses (GLN) was analysed. 93 % of GAN and 89.3 % of GLN were followed up. Cutting out rate of GAN/GLN was 7.0 %/3.1 %, postoperative shaft fractures occurred in 1.0 %/0 %, intraoperative shaft fractures in 1.0 %/2.1 %, problems with distal locking in 2.0 %/1.0 % and deep infections in 3.0 %/1.0 %. In an analysis of internationally published data on 2 241 GAN and 365 GLN the cut-out rate was 2.3 %/0.5 %, postoperative shaft fracture 2.2 %/1.4 %, intraoperative shaft fracture 1.2 %/0.3 % and deep infection 1.2 %/2.2 %. GLN shows lower complication rates with regard to femoral head perforation and late shaft fracture than GAN.