Removal of internal femur fixation (gamma nail)?

1. JimboPenguin 15 June 2012 at 11:23AM
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   I fell off my bike in December 2011 and got myself a 'displaced subtrochanteric fracture of the left femur', i.e. I broke my left femur in half a few inches below the hip joint. The surgeon kindly fixed it with a gamma nail that runs from the knee to the hip and then has a joint with another pin that goes into the part of the femur that forms the hip joint. Six months later I'm walking, starting to cycle and jog and return to normality.

   I am now considering the future - I am very active in cycling, polo, skiing, etc and these are dangerous activities that could result in another break. Having the metal in the leg when breaking it again apparently isn't recommended, so my gut feel is to have it taken out in 6-12 months' time. However, I'm worried about how weak the bone will be because they will need to drill a decent hole or holes in it to remove the gamma nail fixation.

   Are there any papers out there on this topic that I could read? Apologies if this is a repeat thread, I'm brand new to this forum.

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2. Emmett_Brown 27 July 2012 at 10:41AM

   I've also had an injury that matches your description, maybe mine was a little higher up, almost through the trochanter itself. It sounds like you're healing quite well.

   I had my gamma nail removed ~10.5 months after the accident, because of similar concerns as yours. It also gave me pains in temperature changes, and I generally wanted to return to my normal state.

   I checked into the hospital in the morning, the operation itself was under spinal anesthesia, so I was awake throughout. I could leave that afternoon. There should be no bone-drilling required to get the pins back out.

   I was told that there should be no significant strength reduction, just to avoid heavy strain for 2-3 months (IIRC).

   This was followed by just a check-up of the scars 3 weeks later, nothing else. No further physiotherapy or such. I used crutches again for a few days after the operation, but in all, the recovery was nothing compared to the original injury.

   Concluding, I definitely don't regret having it removed. From a structural perspective, I would think that it is also more likely to break your leg with the nail (because the end of the nail creates a weak point), than without (and definitely after the bone has healed up again).

   Good luck!

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