Gamma nail removal

Gamma nail removal

I broke my hip about three years ago and had a gamma nail fitted to fix the fracture. The screw that holds the nail that fits laterally into the head of the femur is causing me pain. I can’t sleep on my right side and spurts of intense cycling (like a spinning or tackling a climb at pace) cause pain the next day. Is it worth having the gamma nail removed to relieve the pain? I’d be interested to know of any complications and the length of the rehabilitation process.

mishinator, via the forum ​

A gamma nail is inserted to fix certain types of fracture of the neck of the femur (thigh bone). These are commonly referred to as hip fractures. It consists of a large screw placed in the head of the femur and a nail, which goes down the middle of the shaft of femur.

Usually, the gamma nail will remain in place permanently, even after the fracture has healed. However, metalwork can sometimes cause pain or discomfort, particularly when a force is put on it, or in certain positions. Depending on how troublesome the pain is, the gamma nail can be removed. This is a decision which should ultimately be taken with your orthopaedic surgeon, after weighing up the pros and cons.

Removal is usually a straightforward daycase procedure, and there is a good chance your pain will be improved. However, as always, there are possible complications, and these include re-fracture of the bone and wound infection. In addition, a number of factors influence how easily the nail can be removed, including the length of time it has been in and whether bone has overgrown the end of it. The hole left by removal of the nail will refill with new bone, which forms over several weeks. You will probably be advised to avoid high impact activities during the first couple of months, but stationary and gentle cycling is usually permitted – check with your surgeon.

Matt Brooks

​​​Cycling GP

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