Breakage of a Third Generation Gamma Nail: A Case Report and Review of the Literature

Table 1

Meta-analyses of Gamma nail breakage.

Author	Total cases	Cases of broken nails	Nail type	Breakage site	Time	Cause of breakage
Valverde et al. [17]	223	1 (0.4%)	1st GN	Proximal	N/A	N/A
Boriani et al. [13]	1181	5 (0.4%)	1st GN	N/A	N/A	N/A
Gaebler et al. [18]	839	2 (0.2%)	1st GN	Distal	4 months	Direct trauma
			1st GN	Distal	5 months	Nonunion
Pervez and Parker [19]	35	2 (5.7%)	Long GN	Middle	3 months	Delayed union
			Long GN	N/A	5 months	Delayed union (PF)
Van Doorn and Stapert [20]	101	2 (2.0%)	Long GN	Proximal	7 months	Nonunion (PF)
			Long GN	Middle	9 months	Nonunion (PF)
Docquier et al. [21]	439	1 (0.2%)	1st or 2nd GN	N/A	N/A	Delayed union
Álvarez et al. [22]	843	5 (0.6%)	1st GN	Proximal	7 months	Nonunion
			1st GN	Distal	7 months	Nonunion
			2nd GN	Proximal	7 months	Nonunion
			Long GN	Middle	10 months	Nonunion
			Long GN	Proximal	8 months	Nonunion
Sehat et al. [23]	100	1 (1.0%)	Long GN	Middle	N/A	Insufficient reduction

1st GN: the first generation Gamma nail, 2nd GN: the second generation Gamma nail, Long GN: long Gamma nail, Proximal: the opening for the lag screw, middle: nail midshaft, distal: the opening for the distal locking screw, N/A: not available in the literature, and PF: pathological fracture.