Experimental Analysis of a Failed Gamma Nail: A Case Report and Literature Review

Abstract

The Gamma Nail represents one of the most popular and efficient implants for treating proximal femoral fractures. Our paper reports a case of a failed Gamma Nail which was used for the surgical treatment of a 69-year-old woman with a right femoral trochanteric fracture due to a car accident. After the surgical intervention, 6 months later, the patient presented to the hospital reporting pain and limited mobility of the right hip. An X-ray was performed at the level of the pelvis, which highlighted the fracture nonunion and the implant failure. The implant removal and its replacement with a dynamic condylar screw system (DCS) was decided. Because Gamma Nail failures are rare occurrences, the implant was subjected to analyses and experimental determinations to find out the cause. For the implant analyses, a stereomicroscope, an optical microscope, and scanning electron microscopy were used. After the tests were conducted, preparation and processing irregularities as causes of the implant failure were eliminated. Also, the experimental analyses showed that the Gamma Nail did comply with chemical composition and microstructure regulations. Thus, it was concluded that the implant failed due to the mechanical overloading caused by surgical technique errors.