Evaluation of a modified technique for gamma nail removal. Accolade ii femoral hip system surgical technique previously lsp76 hipaccolade ii. Gamma3 im nail features and benefits the implant is made from titanium alloy which is friendlier to bone than steal alloys and fixation can avoid metal shielding effect. Cohen states, we believe that the gamma nail is an excellent, if not a better, surgical option over the more traditional methods of hip fracture treatment. This is the third generation of gamma intramedullary short and long fixation nails. Tfn titanium trochanteric fixation nail system surgical technique depuy synthes 7. An intramedullary rod, also known as an intramedullary nail im nail or interlocking nail or kuntscher nail without proximal or distal fixation, is a metal rod forced into the medullary cavity of a bone. The gamma3 ublade lag screw may be used with either the gamma3 trochanteric nail or the long length gamma3 nail to treat patients with.
Technique should not interfere with or replace any chapters in the gamma3 operative technique except for those detailing lag screw insertion and fixation. Stryker gamma3 and t2 intramedullary nailing gamma 3. Gamma nail is possibly not appropriate for subtrochanteric. Tfn set up gamma nail surgical tech, surgical technician. The gamma3 system is designed to facilitate minimally invasive surgery and reduce the or time to a minimum through an instrumentation. Our surgical technique has previously been described in great detail. Gamma3 nail 180 the anatomical shape of the nail is universal for all indications involving the treatment of trochanteric fractures. Break of gamma nail is an extremely rare complication and is reported to be between 0.
Trigen intertan vs stryker gamma3 summary initial stiffness of intertan construct almost 40% greater than gamma3 intertan femoral head rotation and varus collapse initially up to 84% lower than gamma3 after 140,000 cycles, interfragmentary movement on average 33% less on intertan when compared to gamma3. The evolution of the successful trochanteric and long gamma nails as, well as the asia pacific and japanese versions, followed incremental. Used stryker gamma 3 long nail implants and prosthesis for. The gamma locking nail system is based on more than 20 years of gamma nail experience. Acknowledgments introduction this brochure describes the surgical technique to implant the gmk sphere. Intramedullary fixation of subtrochanteric fractures with.
Short gamma nail pdf 15 years of gamma nail experience. Complications and technical problems with the gamma nail. During this period, modifications of design and instrumentation have occurred to combat the intra and postoperative complications that were associated with the use of early designs. It explains the benefits, risks and alternatives, as well as what you can expect when you come into hospital and after you have gone home. For optimal positioning of the gamma3 rc lag screw, use of the gamma3 one shot device is recommended. Lebel e department of orthopaedic surgery shaare zedek medical center. Pdf complications and technical problems with the gamma nail. Gamma 3 short stryker, kalamazoo, mi, gamma 2 and 3 long nails stryker, or synthes trocanteric fixation nail short or long nail synthes, paoli, pa. The principal reason for this is the comparably high op morbidity, which basically results from the exposing of the nail head and may cause postoperative symptoms.
Nof lag screw has a thread so if your screw is wrong length you can ease take out the screw and change it with proper one. The annual participation in the stryker training and education gamma and t2. The new gamma3 system is designed to facilitate minimally invasive surgery and reduce the or time down to a mini mum by the aid of using new instrumentation and an optimized surgical technique. In addition to that, malunion and fracture collapse have been observed less commonly in cephalomedullary nails compared to extramedullary systems 34. First generation gamma nails have been complicated by.
Gamma3 long nail is intended for fixation of stable and unstable femoral fractures occurring from the base of the femoral neck extending distally to a point approximately 10cm proximal to the intracondylar notch including fractures of the basilar neck, intertrochanteric fractures, peritrochanteric fractures, subtrochanteric fractures and femoral shaft fractures. Long nail all nails use the same lag screws, set screw, distal locking screws and end caps see fig. Nail size, screw length and femoral neck angle may be determined. Gamma3 locking nails come in 3 neckshaft angles of 120, 125 and. The humeral nail system can be used with or without the sureshot distal targeting system. All of the lights go off aside from the laparoscopic camera monitors and the focus is entirely on what is going on inside the patient at that moment. The trochanteric gamma3 nail is indicated for fixation of stable and unstable intertrochanteric fractures, including but not limited to nonunion, malunion and tumor resections, while the long length gamma3 nail inidcation may include fractures resulsting from trauma, nonunion, malunion, pathological fractures, impending pathological fractures, tumor resections and revision procedures. Gamma3 ublade lag screw disassembled 3 the standard gamma nail. The long gamma nail has been shown to reduce the incidence of periprosthetic fractures. The nail length may also be determinated intraoperatively using the guide wire ruler together with the guide wire. My skill came not from any intrinsic abilities of my own but rather from knowing how things were supposed to be done and what to pay attention to, which this book taught me. Gamma3 nail 170 and 180 the anatomical shape of the nail is universal for all indications involving the treatment of trochanteric fractures.
Animation adapt for gamma3 intertrochanteric fractures. Gamma nail is a cephalomedullary implant that was developed for the treatment of pertrochanteric hip fractures and has been successfully used for over 20 years. An orthopedic implant is a medical device manufactured to replace a missing joint or bone or to support a damaged bone. Gamma3 long nail gamma3 lag screw 120 125 gamma3 end cap distal locking screws fig. Failure of the stryker gamma 3 nailing system due to nail. The gamma nail, a combination of advantages of the sliding screw with the intramedullary nail, represents an efficient technique in the management of these fractures. Patients were treated with one of the following four cmn. The software assists the surgeon with implant alignment, lag screw length determination, lag screw positioning, and distal targeting. They used short and long gamma 2 and 3 nails stryker as well as short and long trochanteric fixation nails synthes, paoli, pennsylvania and found that the.
Type ii anodization for titanium implants offers increased fatigue strength. Gamma3 nail 180 all nails use the same lag screws, set screw, distal locking screws and end caps see fig. However, long gamma nailing has a wellrecognized risk of anterior cortical abutment or perforation due to anatomical variations in the anterior bow of the femur and poor nail entry point. Enter your mobile number or email address below and well send you a link to download the free kindle app. Leclairmedial pelvic migration of the lag screw in a short gamma nail after hip. Adapt for gamma3, software based instrumentation for the gamma3 procedure. The gamma3 locking nail system was developed based on more than 15 years of gamma nail experience. Gamma3 trochanteric nail 180 cambridge orthopaedics. Expert consult online and print, 1e provides beautiful handdrawn anatomic images along with clear instructions on the performance of each operation. Code information catalog number lg3ot, no lot numbers, this is the surgical technique brochure.
The gamma3 ublade lag screw system gamma3 ublade fig. Im nails have long been used to treat fractures of long bones of the body. Long gamma nail versus short gamma nail in the treatment of. The purpose of this metaanalysis was to compare the costeffectiveness of the long gamma nail as an alternative to second and third generation short gamma nails as the initial treatment of stable intertrochanteric fractures. Practice of intramedullary locked nails springerlink. Dynamic hip screw dhs and gamma nail were commonly used but often associated with some complications, such as fixation failure and implantrelated fractures. Apr 19, 2016 the current study only includes the most third generation of the short cmn, including the stryker gamma 3 short and synthes trochanteric fixation nail short, which have been reported to have decreased rates of postoperative secondary femoral shaft fractures. Gamma3, the newest generation nail system, is designed to facilitate minimally invasive surgery and to help increase or efficiency with the aid of the stateoftheart instrumentation and an optimized surgical technique. All nails use the same lag screws, set screw, distal locking screws and end caps fig.
The objective of this study was to evaluate the clinical outcome of traumatic subtrochanteric fractures fixed with pfn or long gamma nail with particular emphasis on our experience with the surgical techniques. This technique focuses on knee alignment and in setting tibial and femoral. Surgical technique product information mri information 78 tfn titanium trochanteric fixation nail system 2 biomechanical features 3 ao principles 6 indications 7 clinical cases 8 preoperative implant selection 9 open proximal femur 10 insert nail 17 proximal locking 21 distal locking short nails 35 surelock distal targeting device. The average followup was 18 months, 46 % were male, and 71 % had an asa. Internal fixation is an operation in orthopedics that involves the surgical implementation of implants. Internal fixation with a gamma nail, in its short and long versions, is an excellent surgical technique for intertrochanteric and subtrochanteric fractures of the femur. Note as template magnification levels are set at 117%, all measurements are estimates of true size. Accolade surgical protocol previously lasst adm x3 mobile bearing hip system surgical protocol for us previously lsp64 hiprestoration adm. Use of the gamma nail in the treatment of fractures of the. This manual is discribing the surgical technique using a gamma3 trochanteric nail 180. Surgical technique implant selection the trigen intertan nail preoperative template set 71674200 may be used to assist with preoperative implant selection. Many surgical techniques have been reported in the literatures regarding removal of broken implants especially the intramedullary nail from the long bones such as femur and tibia.
Stryker gamma3 and t2 intramedullary nailing gamma 3 2011. Gamma3 locking nailthe gamma3 locking nail system is based on strykers more than 25 years of gamma nail experience. Gamma 3 distal targeting device gamma 3 course venue stryker gamma3 and t2 intramedullary nailing 2011 surgeon course program surgery transmission and cadaver demonstration. Adapt is the only augmented reality instrumentation of its kind. Then you can start reading kindle books on your smartphone, tablet, or computer. The third volume of the practice of intramedullary locked nails places a special focus on recent advancements in understanding the biology of fracture healing of long bones, the emerging technologies that further enhance the minimally invasive nature of closed treatment of fractures, and the availability of various surgical techniques in intramedullary fixation. The short gamma nail stryker, mahwah, nj is a commonly used device for the treatment of stable intertrochanteric hip fractures. Gamma3 ublade lag screw assembled and spreaded gamma3 ublade lag screw end cap fig. The synthes titanium trochanteric fixation nail tfn is in tended to treat stable and unstable pertrochanteric fractures, intertrochanteric fractures, basal neck fractures, and combi nations thereof. The t2 im nailing platform offers a combination of innovation, simplicity and versatility that is designed to suit your various needs. Medial migration of the intramedullary gamma 3 nail a.
Long versus short cephalomedullary nail for trochanteric. Overcoming anterior breaches in the distal femur during. Which surgical strategy is the best one for intertrochanteric fractures remains a controversial issue. Trochanteric gamma nail and compression hip screw for trochanteric fractures. Stryker, gamma3, the compact version of the gamma nail system, operative technique for hip fracture system, trochanteric and long nails. The new system is designed to facilitate minimally invasive surgery through the latest instrumentation and optimized surgical techniques. Xray templates for short and long nails to select the correct implant and the optimal nail angle. Randomized prospective study on the influence distal block. The medical implant is mainly fabricated using stainless steel and titanium alloys for strength and the plastic coating that is done on it acts as an artificial cartilage.
May 06, 20 the gamma 3 locking nail system from stryker is a thirdgeneration intramedullary nailing system for the femur. Evaluation of gamma nails in intertrochanteric fractures. The anatomical shape of the nail is universal for all indications. The authors report an uncommon but potentially fatal complication, medial and intrapelvic migration of the intramedullary gamma 3 nails, recorded after one month of osteosynthesis. Evaluation of a modified technique for gamma nail removal question the indication for removing intramedullary nails in young patients is controversial. This technique is designed to be used with arthritic knees that do not have significant bone loss, major contractures or soft tissue laxity. Stryker gamma3 and t2 intramedullary nailing 2010 surgeon.
The system is the result of over 25 years of continuous innovation and clinical history. Adapt allows surgeons to see, adjust, and refine tip apex distance intraoperatively with software. Internal fixation is an operation in orthopedics that. Stryker gamma nail to treat a hip intertrochanteric fracture. The stryker gamma locking nail system is based on more than 15 years of gamma nail. Apr 22, 2020 this study reports on a navigationassisted insertion technique for fixation of proximal femoral fractures. Gamma nail in the treatment of closed trochanteric. The cosmetic appearance of her first toes was acceptable. The strasbourg team has implanted over 5200 gamma3 nails. Long nail all nails use the same lag screws, set screw, distal locking screws and end. The gamma 3 locking nail system from stryker is a thirdgeneration intramedullary nailing system for the femur. Gamma nail in the treatment of closed trochanteric fractures. Gamma3 nail long this nail incorporates several important mechanical design features.
Each nail is supplied sterile packaged together with a set screw in one box. Surgery for hip fracture intramedullary nail insertion this leaflet aims to answer your questions about having surgery for a hip fracture. Oct 10, 2010 one of the major setbacks discovered with the use of the gamma nail is a higher reoperation rate as a result of a new fracture around the implant. Proximal femoral nails antirotation, gamma nails, and dynamic. Two mechanical failures with breakage of the nail were encountered due to proximal varus malalignment, of which one was treated with exchange nailing and grafting and the other one by removal of the broken hardware, bladeplating, and bone.
This is the third generation of intramedullary short and long gamma fixation nails. Surgical nail ablation followed by volar skin coverage of dorsal surface of the distal phalanx bone by using triple flap technique is an effective surgical treatment method for the correction of advanced nail plate deformities requiring total nail ablation. Gamma3 ublade lag screw in the gamma3 trochanteric nail 180 fig. I found basic surgical techniques so helpful that ive recommended it highly and gifted it to other med students. Titanium trochanteric fixation nail system surgical technique depuy synthes companies 3. The medial migration of the intramedullary gamma nail is a rare complication. Short gamma nail fixation for intertrochanteric fractures in.
Gamma is a comprehensive intramedullary nailing system for the treatment of a wide range of proximal femur fractures as well as associated femoral shaft fractures. A series of 224 fractures of the proximal femur in which this nail was used is reported. For citation, use not the present reference but that of the original publication. Long gamma nail in the treatment of subtrochanteric fractures. Intertrochanteric and subtrochanteric hip fractures. With a tip of the greater trochanter entry point and both recon and antegrade femoral locking options, it offers an efficient treatment option for multiple indications. Revision as a cause for surgery has been defined as a secondary surgery with gamma nail following a failure of previous fixation in. The nails are manufactured from an anodised titanium alloy.