From May 1995 to July 1999, we operated on 57 cases with trochanteric and subtrochanteric fractures of the femur, using the gamma nail on 54 cases, IMHS on 2 cases, and ¥ nail on 1 case. In this study, we evaluated the post-operative results of the ambulation status and alteration of X-rays. Twenty nine patients (85.2%) regained the ability to walk. Five of the 7 patients who did not regain the ability to walk had senile dementia. To evaluate alteration in X-rays, we defined two types of reduction pattern, focused on the aligment of the calcar femorale; one is “sinking type”, and the other is the “gearing type”. During the process, the degree of telescoping and decrease of collodiaphyseal angle were larger for the sinking type. For alteration in X-rays, we could not detect significant differences between the trochanteric fracture and subtrochanteric fracture, not for the position of the lag screw.
Result of this study indicated that the reduction of the calcar femoral is important thing in the treatment of trochanteric and subtrochanteric fractures with gamma nails.
