Hi,
Given the large volume of documents on the internet and the modest
pricing of your question, I have attempted to locate some helpful
resources for you without spending an inordinate amount of time on the
question.
First, here is an excerpt from Campbell's Operative Orthopaedics, 9th
ed.
"Short, interlocking intramedullary devices, such as the gamma nail
and intramedullary hip screw, have been introduced for use in
intertrochanteric fractures, and femoral reconstruction nails have
been used for difficult fracture patterns. These intramedullary
devices are theoretically more load-sharing with the medial cortex of
the femoral neck than are lateral cortical constructs. Because of the
more medial placement of the intramedullary nail compared to the side
plate of the compression hip screw, the bending moment at the
nail-screw junction is lower than that at the plate-screw junction.
Other potential advantages of intramedullary fixation include a
smaller operative exposure and possibly a shorter operative time.
To date, clinical studies with the gamma nail and similar devices have
not demonstrated a clear advantage in the treatment of most
intertrochanteric fractures. Goldhagen et al. compared the gamma nail
to a compression hip screw and found no differences in surgical time,
blood loss, or fluoroscopy exposure. Clinical rates of healing have
been similar for the two devices, but a 3% to 6% incidence of
secondary fracture at the tip of the intramedullary device has been
reported. The gamma nail does appear to have some advantage in certain
unstable fractures, especially those with reverse obliquity and
subtrochanteric extension that cannot be easily treated with standard
hip compression screws."
(Retrieved from MD Consult, a password-protected medical resource.)
Also, this seems to be a good overview and resource, written by an MD.
http://www.hwbf.org/ota/otad/mbau/exp.htm
Other sources that I found to help with your project--
The Gamma nail for peritrochanteric fractures [Abstract].
http://216.239.51.100/search?q=cache:d_HgO8NNEJIC:www.medmedia.com/j1/203.htm+gamma+nail+&hl=en&ie=UTF-8
the structural integrity of the gamma nail
http://www.utc.fr/esb/esb98/abs_htm/659.html
Avascular necrosis of femoral head after gamma-nailing for unstable
intertrochanteric fractures
http://link.springer-ny.com/link/service/journals/00402/bibs/1121009/11210505.htm
Prospective Randomized Controlled Trial of an Intramedullary Nail
Versus Dynamic Screw and Plate for Intertrochanteric Fractures of the
Femur
From: the Journal of Orthopaedic Trauma
August 2001 (Volume 15, Number 6)
http://216.239.51.100/search?q=cache:gLnPl51eszUC:www.medscape.com/viewarticle/405105_3+gamma+nail+femur&hl=en&ie=UTF-8
Comparison of Compression Hip Screw and Gamma
Nail for Treatment of Peritrochanteric Fractures
http://www.smaservicesinc.com/soa/jsoafl97/4text.htm
Also,
I did a Medline search for “gamma nail” limited to items with
abstracts. There are 165 journal articles. I have access to a number
of scientific journals through my university computer system and
library if we need to look at more full-length articles. This should
link you to my search.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=PubMed
Search Strategy:
gamma nail intertrochanteric
://www.google.com/search?hl=en&lr=&ie=UTF-8&oe=UTF-8&q=gamma+nail+intertrochanteric&spell=1
I do hope this helps. Please let us know if you need more assistance,
Sincerely,
RMH |
