Multicenter trial of modified Gamma nail in East Asia.

The mismatch of the standard Gamma nail in the Chinese femora led to the modification of its femoral shaft component based on the anthropometric study of 28 pairs of Chinese femora. A multicenter clinical trial was done in 6 countries and regions in East Asia. Three hundred forty-nine fractures were treated and studied. More than 60% of the fractures were unstable by Evans classification. The average age of the patients was 73.6 years. The male to female ratio was 2:3. The mean followup period was 11.7 months. The result of the trial showed that the intraoperative complication rate was 7.7%, and complications primarily were related to faulty operative technique. There were 7.2% postoperative complications related to the fractures that again decreased toward the later stage of the trial. Functionally, there was progressive improvement of the hip score within the followup period. The results show that the modified Gamma nail gave better results in the treatment of geriatric trochanteric fractures by minimizing reaming, thereby reducing complications related to the implants.