The authors present analysis of a group of 75 patients with the fracture of proximal femur treated by the Gamma nail. The group consisted of 24 male and 51 female patients, average age 74 years (ranging from 24 to 91 years). Most frequent were intertrochanteric unstable fractures (Kyle III) - 41 %, subtrochanteric fractures accounted for 27 %. The average duration of the surgery was 70 minutes, the duration of x-ray exposure was 2,6 minutes. Healing in anatomical position was achieved in 91 %. Recorded were 8 peroperative complications (rotation of the head, inadequate reduction - 3 times, cut-out of the screw from the head - twice, breaking of the femoral shaft by the nail, erroneous distal locking). Early postoperative complications were represented twice by haematoma in the surgical wound. Late complications occurred 8 times (aseptic necrosis of the head - twice, cut-out of the screw from the head - twice, breaking of the nail, breaking of distal locking screws, migration of the distal locking screw - twice, mitigated infection - once). Most complications related to subtrochanteric fractures. The comparison with the authors group of patients treated by Ender nail shows in case of the Gamma nail a slightly higher percentage of final good results (88 % versus 91 %), but significantly lower percentage of complications. In the group treated by Ender nailing the mortality within 3 months after operation amounted to 37 % while in case of the Gamma nail only to 25 %. Key words: proximal femur fractures, Gamma nail, outcomes and complications.

Ortopedicko traumatologická klinika 3 LF UK Praha

Is distal locking with IMHN necessary in every pertrochanteric fracture?