Influencia de los cerrojos distales en el tratamiento de las fracturas trocantéreas estables mediante clavo gamma

One hundred consecutive patients, older than 60 years, with stable trochanteric fractures were treated with gamma nail: 50 of them with distal locking screws and the other 50 without them. We performed a prospective surgical and clinical comparative study between both groups, with a minimum follow-up of three months. Opcrative complications were found in 18% of cases in the group with distal locking, all of them during the implantation of the distal screws; and in one case in the group without distal screws, which forced its placing. Healing was always achieved, without diferences for walking ability. Complications during follow-up were not observed in the group treated with distal locking, but in the other group two proximal femoral fractures of the external cortical ocurred, although they do not need additional treatment. Our results support the hypothesis that distal locking screws are not necessary for the treatment of stable trochanteric fractures with the gamma nail.