Complications in Treatment of 31-A Fractures with Trochanteric Gamma Nail (TGN) Versus Gamma3 Nail (G3N) - A Review of 217 Cases

R. Schupfner1, *, #, L.T. Käsmann2, #, W. Wagner1, A.P. Schulz2
1 Department of Traumatology, Orthopaedics & Reconstructive Surgery, Clinic Bayreuth, Germany
2 Department of Orthopaedics & Traumatology, University of Lübeck, Germany

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© Schupfner et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Traumatology, Orthopaedics & Reconstructive Surgery, Clinic Bayreuth, Germany; Tel: +49 921-4005311; E-mail:

These authors contributed equally to the manuscript.



The aim of this study was to clinically evaluate two generations of intramedullary gamma-nail used in the treatment of 31-A femur fractures.

Materials and Methods:

In two consecutive series, 117 trochanteric gamma nails (TGN) and 100 Gamma3 nails (G3N) were implanted for the treatment of inter- and subtrochanteric fractures between 2009 and 2011. Clinical and radiological follow-up examinations were assessed. An analysis of surgical time, hemoglobin drop and complications were performed.


Average surgical time, fluoroscopy time, haemoglobin drop and length-of-stay (LOS) were similar in both groups. No significant differences were found in surgery-related complications like wound hematomas (p=0,59), abscesses (p=0,38), wound infections (p=0,69) and Cut-outs (p=0,69) between the two groups. The cumulative surgery-related complication rate was higher in the TGN group compared to the G3N group (13,68% vs. 8%) but this did not reach statistical significance (p=0,2).


Our findings suggest that both TGN and G3N allow adequate treatment of trochanteric fractures with an acceptable complication rate.

Keywords: 31-A fracture, Complications, Elderly gamma3 nail, Intertrochanteric fracture, Trochanteric gamma nail.