Outcome in 36 elderly patients treated with the Gamma3 Long Nail for unstable proximal femoral fracture.

The results of a series of 36 elderly patients with proximal femoral fracture distal to the intertrochanteric line treated with the third generation long Gamma nail are presented. Outcome was comparable with the second generation nail in terms of 1-year mortality, length of stay, surgical complications and re-operation rate. No patients required reoperation for construct failure. Medical complications and reduction in post-operative function were relatively high in an elderly population with significant pre-existing comorbidities but 3 in 4 were independently mobile on discharge from the acute orthopaedic unit. Charlson Comorbidity Index > 5 on admission is identified as a predictor of increased mortality. The Gamma 3 Long Nail is shown to be a suitable implant for the treatment of these fractures. Little tangible benefit of this nail's new instrumentation is seen, with similar operative time to its predecessor, and more units of blood transfused.