Outcome of intertrochanteric femur fractures treated with Gamma intramedullary nails: A prospective study from a resource-limited setting

Objective: This study aims to present a single-center experience in the management of “intertrochanteric fractures” using Gamma intramedullary (IM) nailing, while also assessing the outcome and complications associated with this approach. Method: In this prospective study, 72 patients diagnosed with “intertrochanteric fractures” were treated with Gamma IM nails from April 2021 to March 2023. The main outcome was hip function one year following surgery, using the Harris hip score (HHS). The second aim was to identify the factors associated with postoperative complications. Results: The mean age of the participants was 64.4 ± 4.6 years, and the majority of the patients were female (n = 44, 61.1%). The mean time to union was 15.69 ± 2.72 weeks. At the one-year follow-up, the mean HHS was 84 ± 6.1 points, with a majority of patients (n = 43, 59.7%) achieving a good HHS. An excellent HHS was observed in 11 (15.3%) patients, while a fair score was noted in 15 (20.8%) patients and a poor score was observed in 3 (4.2%) patients. Postoperative mechanical complications were identified in 14 (19.4%) patients, which included failure of osteosynthesis in 4 (5.6%) cases, surgical site infection in 3 (4.2%) cases, nonunion in 3 (4.2%) cases, mal-union in 2 (2.8%) cases, cut-out in one (1.4%) case, and local pain in 1 (1.4%) case. The factors associated with these complications included high-energy trauma (p = 0.028), longer time to surgery (>48 hours) (p < 0.001), the presence of diabetes mellitus (p = 0.001), hypertension (p = 0.037), increased intraoperative blood loss (p = 0.012), and a higher AO classification (p < 0.001). Conclusion: Our study indicates that Gamma IM nails may effectively manage “intertrochanteric fractures", leading to satisfactory hip function in the majority of patients.