Unstable subtrochanteric fractures--gamma nail versus dynamic condylar screw

We reviewed the operative treatment of subtrochanteric fractures. Before 1999, 15 fractures were treated with a dynamic condylar screw (DCS) and after 1999, 11 fractures were treated with a gamma nail (GN). The mean age of all patients was 70 (31-92) years, and the mean follow up was 16 (9-30) months for the DCS group and 14 (6-26) months for the GN group. All fractures united. There were no infections or implant cut out. In the DCS group, there was one malunion in varus and one late fracture of the implant. In the GN group, there was one malunion in internal rotation and three intraoperative fractures. Functional evaluation showed no significant differences in pain, range of movement, or walking ability, but recovery was significantly earlier in the GN group.