Abstract
Out of 38 patients treated with Gamma nails for trochanteric fractures and followed for 3 months or more after surgery, 3 suffered refracture in a fall or other accident. This communication reports on the follow-up of these three patients. They included one man and two women ranging in age from 84 to 88 years. Two patients who had not been inserted distal locking screws developed subtrochanteric spiral fractures and were then treated by the insertion of distal locking screws. One of them subsequently sustained a fracture of the shaft of the femur in a fall 4 months later, which was repaired using a long version of Intramedullary hip screw. The remaining patient was initially inserted distal locking screws, but suffered a spiral fracture around the nail. Since using of a Gamma nail without distal locking screws can give rise to rotational instability, we make it a rule to use distal locking screws in the treatment of all trochanteric fractures.
