الفهرس 
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Abstract
Trochanteric fractures are common fractures among elderly people resulting mainly from low energy trauma. Fracture reduction should aim for accurate realignment because it is considered a reliable indicator for successful surgical outcome.
The aim of the study is to detect the failure rate of unstable inter-trochanteric fracture fixed with gamma nail in elderly people.
The study is a prospective study included 70 patients with unstable inter-trochanteric fracture admitted to El-Hadra University Hospital and fixed with gamma nail at period between December 2021 and June 2022 with mean follow up period 9.45 ± 2.07. The age of the patients ranged from (60-99) years old. Nineteen patients (27.1%) were male and 51 patients (72.1%) were female.
Twenty-nine patients (41.4%) had right sided fracture and 41patients (58.5%) had left sided fracture. Forty sex (65.71%) patients suffered from intertrochanteric fracture due to low energy trauma such as simple fall down and 24 patients(34.2%) due to high energy trauma (RTA). Fifty patients had pre-existing medical condition and twenty with no significant comorbidities .Eighteen patients (25.7%) were dependent in their daily basic life needs, 52 patients (74.2%) were self- dependent.
The fracture pattern of the seventy patients were classified according Evans classification system using x-rays into 16 patients (22.9%) typeIII,27 patients (38.6%) type IV,17 patients (24.3%) type V and 10 patients (14.3%) type VI (reversed obliquity fracture).
Sixty patients (85.71%) underwent closed reduction and ten patients underwent open reduction (14.28%). Quality of reduction of all patients was assessed immediate post-operative according to (BRQC)(100). 35 patients (50%) with good reduction, 25 patients (35.7%) with acceptable reduction and 10 patients (14.3%) with poor reduction quality.
All patients were assessed clinically using Harris Hip Score (HHS) and radio-logically using p-x-ray 6 months post-operative with mean of follow up period 9.45 ± 2.07.
The mean Harris Hip Score of patients in our study was