
Clinical Effects of the Gamma Nail + 
femoral neck fractures, nonunion, femoral neck necrosis, femoral head necrosis, trauma
CAVITY, COMPLICATIONS, INTRAOPERATIVE BLOOD LOSS
In this clinical retrospective study, the Gamma nail + CCS group had a longer operation time, greater intraoperative blood loss, and longer hospital stay than the CCS group, which might be associated with medullary reaming, opened medullary cavity, and blood sinus in the proximal femoral cancellous bone.In addition, we found no significant difference in Harris hip scores at 12 months between the Gamma nail + CCS and CCS groups (p = 0.923). During follow‐up, we noted one case of femoral head necrosis in the Gamma nail + CCS group (15 patients) and two cases of femoral head necrosis in the CCS group (16 patients), with no nonunion in either group. No statistical difference was found between the two groups in terms of the rate of femoral head necrosis. Among patients with femoral neck necrosis in the CCS group, one patient showed significant withdrawal of the cannulated screws 5 months after surgery, whereas in the Gamma nail + CCS group, all patients, including those with femoral neck necrosis, showed no loss of stability of the fixation, indicating that a major advantage of Gamma nail combined with one CCS fixation was reducing the risk of femoral neck necrosis due to loss of stability of the internal fixation. The results of the retrospective follow‐up revealed that although Gamma nail combined with one CCS fixation caused more trauma than three CCS fixations, and was not inferior in terms of complications and function, it may reduce the complications caused by unstable instrumentation. Further, the cost of the equipment used for the Gamma nail combined with one CCS fixation is three to four times that of the three CCS fixations; thus, Gamma nail combined with one CCS fixation is only recommended for treating serious Pauwels type III femoral neck fractures.