Three Cases of Secondary Femoral Shaft Fracture after Operation Using the Gamma Nail

Abstract

We report three cases of secondary femoral shaft fracture after operation for intertrochanteric and subtrochanteric femoral fracture using the gamma nail. All cases were treated using the gamma nail with distal locking screw. All secondary femoral shaft fractures occurred at distal locking screw. We treated these fractures using the long gamma nail.
Concentration of stress to distal locking screw may be one of the causes of secondary femoral shaft fracture. But other reports recommend use of the distal locking screw, especially subtrochanteric femoral fracture, to prevent secondary fracture due to torsional load and to stop subsidence and rotation of the nail. It is necessary to discuss whether to use the distal locking screw when using the gamma nail.