Gamma versus DHS nailing for extracapsular femoral fractures. Meta-analysis of ten randomised trials.

A meta-analysis has been carried out of all published randomised trials which compare the gamma with the DHS nail, giving in a total of 1794 patients with extracapsular femoral fractures. Results showed that the Gamma nail had a significantly increased risk of fracture of the femoral shaft and an increased reoperation rate. There was no difference in the lag screw cut-out rates, incidence of wound infection or length of stay in hospital. The gamma nail cannot be recommended for routine use in trochanteric fractures until the problem of femoral shaft fracture is resolved.