Usefulness of Predrill Procedure on OneShot Guide for Gamma Nail

Abstract

We investigated the usefulness of predrill procedure with Gamma nail using OneShot Guide. From April 2003, we performed the procedure on 22 proximal femoral fractures (two basicervical neck fractures, 17 trochanteric fractures, three subtrochanteric fractures) with Gamma nail according to OneShot Guide utilizing the predrill procedure (the predrill procedure group). To compare with this group, 104 cases (12 basicervical neck fractures, 84 trochanteric fractures, eight subtrochanteric fractures) for which we did not use the predrill procedure were assigned to the control group. The average time of the operation was 44.1 minutes (the predrill procedure group), and 52 minutes (the control group). The average time of irradiation was 360 seconds (the predrill procedure group), and 261 seconds (the control group). Twenty-one out of 22 cases (95.5%) achieved ideal insertion of the lag screw in the predrill procedure group, and 96 out of 104 cases (92.3%) in the control group. It is important to insert the lag screw at the appropriate position with Gamma nail, and this possible at a higher rate using both the predrill procedure and OneShot Guide than using only OneShot Guide.