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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
Bone Remodeling and Repair01:31

Bone Remodeling and Repair

Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during bone...

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Related Experiment Video

Updated: Jun 14, 2026

A Reliable and Reproducible Critical-Sized Segmental Femoral Defect Model in Rats Stabilized with a Custom External Fixator
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Gamma 3 vs Gamma 3 RC in Unstable Extracapsular Hip Fractures: A Prospective Randomized study.

Jose Antonio Valle-Cruz1, Yaiza Lopiz2,3, Daniel Garríguez-Pérez1

  • 1Department of Traumatology and Orthopaedic Surgery, Clínico San Carlos Hospital, Madrid, Spain.

International Orthopaedics
|December 4, 2025
PubMed
Summary

The U-Blade (RC) lag screw did not improve mechanical complication rates for unstable hip fractures compared to the standard Gamma3 nail. Radiographic factors like TAD, reduction quality, and screw placement are key predictors of fixation failure.

Keywords:
Gamma3 nailHip fracturesIntertrochanteric fracturesMechanical complicationsRotational instabilityU-Blade lag screw

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Area of Science:

  • Orthopedic surgery
  • Biomechanics
  • Trauma care

Background:

  • Rotational instability is a significant cause of fixation failure in extracapsular hip fractures.
  • The U-Blade (RC) lag screw was developed to enhance rotational stability.
  • Comparing the Gamma3 nail with the Gamma3 RC nail is crucial for optimizing treatment outcomes.

Purpose of the Study:

  • To compare mechanical complication rates between the Gamma3 nail and the Gamma3 RC nail.
  • To evaluate the efficacy of the U-Blade (RC) lag screw in reducing fixation failures.
  • To identify risk factors for mechanical complications in elderly patients with unstable extracapsular hip fractures.

Main Methods:

  • A prospective, single-center randomized controlled trial was conducted.
  • 316 elderly patients (≥65 years) with rotationally unstable extracapsular fractures were included.
  • Patients were randomized to receive either the Gamma3 nail (n=169) or the Gamma3 RC nail (n=147).

Main Results:

  • The overall rate of major complications was 2.9 per 10,000 person-days, with cut-out being the most frequent (2.2%).
  • No significant difference in major complication rates was observed between the Gamma3 and Gamma3 RC groups (RR=1.0; 95% CI: 0.4-2.7).
  • Increased Total Arthroplasty Distance (TAD) > 25 mm, superior screw placement, and postoperative diastasis were associated with higher risks of major complications.

Conclusions:

  • The U-Blade (RC) lag screw did not reduce mechanical complication rates compared to the standard Gamma3 nail.
  • Radiographic parameters, including TAD, reduction quality, screw position, and postoperative diastasis, are primary predictors of fixation failure.
  • Optimizing reduction quality and screw placement is essential for preventing fixation failure in extracapsular hip fractures.