A new perspective towards failure of gamma nail systems.

Abstract:

:Uncommon causes of nail failures and surgical reinterventions were determined. The study included 23 osteoporotic patients, 13 of whom followed a fast recovery program with early walking (FWB group). The other 10 patients were not allowed full weight bearing until 6 weeks (NFWB group). The T-score was determined before surgery for all cases. A case with a nail breakage after a failed DCS implant fixed in another clinic was also analyzed. The nail was revised and the broken implant underwent a metallurgic and microscopic examination. The average T-score was 2.5 for the patients that followed the fast recovery program and 2.7 for the patients from non-full weight bearing. Four patients, 1 from the NFWB group and 3 from FWB group, presented a screw cut-out. It was found that the errors of the guiding instruments may create dents, scratches or micro-fractures on the titanium coating that lead to an early implant failure. Imperfect reduction leads to incorrect implant placement and a high incidence of failure. Damaging the titanium protective coating, in a low force, high cycles scenario can cause structural failure. Delays in fracture healing and material fatigue are the most common causes of nail failure and can lead to catastrophic complications.

journal_name

Exp Ther Med

authors

Dragosloveanu Ş,Dragosloveanu CDM,Stanca HT,Cotor DC,Dragosloveanu CI,Stoica CI

doi

10.3892/etm.2020.9346

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

216

issue

6

eissn

1792-0981

issn

1792-1015

pii

ETM-0-0-09346

journal_volume

20

pub_type

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