الفهرس 
Mandatory Basic ScienceOnly 14 pages are availabe for public view
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Abstract
Inter-trochanteric femoral fractures occur between the greater and
lesser trochanters and are commonly observed in the elderly it is one of the
most important causes of mortality and morbidity in the geriatric
population.(4)
The incidence of trochanteric fractures has increased significantly
during the last few decades becoming important in terms of social and
economic issue.(2) Currently, internal fixation devices for treating unstable
inter-trochanteric femoral fractures are classified into extra-medullary and
intra-medullary fixation devices, both of which show advantage and
disadvantages.(13)
Extra-medullary fixation, as the dynamic hip screw (DHS) method,
has always been universally accepted as the ”gold standard” for treating
intertrochanteric femoral fractures. However, DHS method has a relatively
high failure rate in treating unstable intertrochanteric femoral fracture.(75)
The gamma nail is a classic intramedullary fixation device for
treatment intertrochanteric fractures that was developed by combining the
sliding hip screw and intramedullary nail system.(77)
Primary nail is placed in the intra medullary cavity, creating central
fixation. Several advantages of the gamma nail have been proposed, such
as its application to the femoral head and neck and femoral shaft to increase
stability at fracture sites and to promote healing.(77)
In addition, its fixed application through the medullary cavity allows
for early functional exercise and full weight-bearing of the affected
limb. The standardized surgical technique for implementing gamma nails is
accessible for surgeons, and the duration of operation is short, resulting in small operative wounds. However, it is unsuitable for patients with occlusive medullary cavities, very large anterior arches in femur shafts, and
those with the risk of fat embolism. The complications of the gamma nail
include aggravated intertrochanteric fractures and stress fractures of the
distal femoral shaft during the insertion of the main nail.(77)
The aim of this study was to evaluate the results of management of
unstable intertrochanteric femoral fractures by gamma nails.
This prospective study was done among 20 patients diagnosed as
unstable intertrochanteric fractures of the femur (Kyle type III & IV and
Boyd & Griffin type II & III), treated with caphalo-medullary nails. The
study was conducted at El-Menofia University hospital and Luxor General
Hospital.