HOW DOES GAMMA COMPARE TO TFN???

Discussion in 'Stryker' started by Anonymous, Aug 3, 2006 at 11:50 PM.

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GAMMA OR SYNTHES TFN BETTER

Poll closed Sep 2, 2006.
  1. GAMMA

    0 vote(s)
    0.0%
  2. TFN

    0 vote(s)
    0.0%
  3. SAME

    0 vote(s)
    0.0%
Multiple votes are allowed.
  1. Anonymous

    Anonymous Guest

    Both work fine.
    I.V.Hall of Synthes stated that disruption of the reduction does occur when fucking wacking away at that helical blade trying to get it to move another 10mm. Great fixation at a cost that alot of surgeons will not want to accept. That is, a blade that is still 10-15 mm from head center that no matter how hard you pound is not advancing. Fracture gap just keeps getting bigger and bigger. "Can I take this thing out and predrill" asks the surgeon. Good luck with that one. It ain't gonna happen in the next hour but sure give it a shot doc. Or "Can I just leave it be at this point and use the interfrag compression wheel to reduce my newly acquired fracture gap". Sure then you'll have a blade that is 10mm proud and a pissy grandma coming back to your office. Or a blade that is short of where it needs to be thus increasing the risk of cut out. Or a blade that has not fully reached its rotated position to allow for set screw engagement. You'll be left with a sharp flute located superiorly. Not a good move.

    Believe what you will about the "superior" cutout resistance of the helical blade. Try telling that to a surgeon who has performed 500 gammas and another 500 DHS without a single cutout. He'll laugh at you. Try showing him the dense foam model study "proving" that the TFN is much better at resisting cutout despite all 3 constructs lasting enough cycles to allow for bone healing. Oh wait, there was no bone healing--it was a dense foam surrogate. What a crock of shit study in proving anything clinically relevant.

    The Gamma3 is the easiest cephalomedullary to use on the market. In my territory the TFN had a 2 year head start with no Stryker representation and no Gamma3. Alot of people tried it, probably about 5 users now. 3 Gamma users all switched to Gamma3. And another 20 surgeons now routinely use the Gamma3. If I was a loyal Synthes surgeon I'd probably find a way to continue to use the TFN despite its weaknesses. It's an adequate device. It will do the job. But if I feel no allegiance whatsoever and want to use the easiest nail with the best outcomes I'm gonna use the Gamma3.
     

  2. Anonymous

    Anonymous Guest

    Good post
     
  3. Anonymous

    Anonymous Guest

    I love how many Gamma 3's break in my area...great selling point. Thanks Stryker for coming out with a great product that keeps the TFN number 1!
     
  4. Anonymous

    Anonymous Guest

    Only thing keeping TFN going my area is hospital red tape. Iv'e got docs utlizing Gamme3 & getting good results consistantly in under 15 min. incision to locking screw.

    Sorry....DHS & TFN are a step behind Gamma3 out here.
     
  5. Anonymous

    Anonymous Guest

    Any argument about "banging" in the blade versus advancing a lag screw is moot. The reality is that Tip Apex Distance means everything. Synthes finally has some real competition and is struggling to deal with it.
     
  6. Anonymous

    Anonymous Guest

    Heywood Jablomi
     
  7. Anonymous

    Anonymous Guest

    If gamma was such a great implant, why has Stryker had to revise it twice since inception. Each time looking more and more like a TFN, sizes available, lag screw diameters,etc. Stryker blows.
     
  8. Anonymous

    Anonymous Guest

    very well said, stryker has the only patented system that allows surgeons to micro adjust for TAD. Aside from that, the surface area of the gamma3 lagscrew is much greater than the three tines of the helical blade.
     
  9. Anonymous

    Anonymous Guest

    you sir are a monkey..

    your patented device pays s&n everytime you use it

    by the way tfn is better i just got hired by stryker power i was a scrub tech so i use them all

    the tfn is always faster and easier
     
  10. Anonymous

    Anonymous Guest

    Just curious, what are the synthes reps saying in there sales presentations to surgeons when they pitch the TFN? Personally I think the TFN is faster and much easier to use.
     
  11. Anonymous

    Anonymous Guest

    This man is a little ignorant. Do you know how much of ortho and medicine in general is OFF LABEL? Untill probably 7-8 years ago most porous coated hip stems were off label and for cemented use only, yet we have 25-30 year data on them being press fit in the US. A huge segment of spine is all off label, from using BMP to pedicle screws. Keep listening to your product managers and keep losing out on sales. Stryker changes their tune to suit their line. I like how suddenly metal on metal is okay now that Stryker can market the Cormet. Gamma is fine, TFN is better. I would worry more about selling locking plates.
     
  12. Anonymous

    Anonymous Guest

    sales pitch?

    Anyone using a good sales pitch for the tfn? What are you saying that is swaying a doc to go with it Vs GAMMA?
     
  13. Anonymous

    Anonymous Guest

    Radius of curvature of TFN is better than Gamma 3 nail. What does that mean? Take a lateral xray and you will see that the gamma 3 impinges on the anterior cortex. Patients complain of knee pain. Gamma long nails are straighter and the TFN has more curve. Femurs aren't straight.

    Ease of use. TFN is very easy and has a lot less steps. Gamma good but doesnt touch TFN.

    Since Stryker went to a 15mm opening reamer for their nail, the nail is breaking.

    Oblique locking hole for short nails (TFN) vs. Straight Static for Gamma. TFN allows for motion. Dont see femur fractures below a short nail with TFN.

    I dont work for Synthes. I'm a PA for well known Orthopaedic Surgeon who recently switched to TFN.

    Sorry
     
  14. Anonymous

    Anonymous Guest

    Check out the thread entitled 'TFN Removal' on the Synthes board. There are pros and cons in the posts but there are also some serious problems with the device.
     
  15. Anonymous

    Anonymous Guest

    The easiest to use hip fx device in the hosp and the reps take care of us

    some guys use gamma but it's going away
     
  16. Anonymous

    Anonymous Guest

    Firm beliver in TFN, better cut out resistance, off set screw holes, built in set screw, no predrilling for a lag screw, significantly less bone is removed. Both are good devices but TFN is better for time being. I hope some engineer out there will figure out the "perfect" IM device soon.
     
  17. Anonymous

    Anonymous Guest

    Come on guys do your research. What do you mean you couldnt find anything on the internet. Its the INTERNET. Saying you cant find something in the library or perhaps in a medical journal is one thing....but the internet.
    Here is the link for Orthofix. It has answers to everything that you were looking for.
    http://www.orthofix.com/products/veronail.asp?cid=10
     
  18. Anonymous

    Anonymous Guest

    Anyone reading this should first of all be promoting the best implant for the fracture pattern. You should also know the difference between Inter, Per, reverse, and Sub-Trochanteric Proximal Femur Fractures before you start talking about devices. Then you should look at the supporting data. We work in an evidence based field

    Stable Trochantenric Fx's (anyone?) where the medial cortex is in tact is treated more than adequately by any sliding compression screw device and there is ample data to support that. The cost-benefit choice of DHS which has been shown to provide similar results to the more expensive option of IM Nails.

    Unstable Trochanteric Fx's are where it gets tricky and even IM Nails aren't the clear winner on these with complication rates quoted in the 6-15% range.

    Apart from the change in mechanical advantage from the DHS -> IM Nail, I can't see any technical improvement in lag screw type cephalomedullary devices. Biomechanical testing and radiographic review of cut out shows that rotation of the head and neck is the main cause. Reducing the TAD reduces the rotational forces around the lag screw by ensuring the forces translate through the screw (not around it) leading to a reduction in cut out.

    If you can provide more rotational control of the head and neck then there is an advantage to be gained. The TFN and the PFNA (european and asia pacific model) provide this with the helical blade. Love or hate it, it does provide that advantage. Would you rather stand on a round log or flat platform?

    Issues around "Banging" are educational and a good rep will take their time to ensure the surgeon is comfortable with this technique.

    At the end of the day, the vast majority of the patients these devices are implanted into are elderly with some level of osteopenia. 26% die before regaining mobility and 42% never regain full mobility. Some innovation is required to improve those statistics.

    All I'll say from here is that I've seen more Gamma3 revisions in the last 12 months than PFNA revisions.
     
  19. Anonymous

    Anonymous Guest

    Doesn't Gamma 3 mean the "third version" of the Gamma Nail? I heard that Stryker is coming out w a Gamma 4 (how many versions is it going to take to get the nail correct). The Gamma 4 is supposed to have an internal set screw (sounds familiar to the TFN), also the Gamma 4 long nail is supposed to have an anatomic anterior bow (again sounds familiar to the TFN). Sounds like there may be patent infringement w the Gamma 4. Stryker Reps loved jumping on the bandwagon about a method of use patent infringement between Synthes and Smith & Nephew and stated that the TFN would be taken off the shelf. That did not happen.

    Question: Where is your Proximal Humeral Nail now? Method of Use Patent Infringement is much different than an implant patent infringment.

    Sounds like Stryker is in a Dog Fight. 3 FDA warnings in 18 Months (Orthopaedics x 2, Biotech x 1). Also, has anyone ever heard of a company winning a lawsuit against the Federal Government (FDA and DOJ). I love the sound of sqeeky hips, I believe that this is a Class Action Lawsuit pending as well.

    Getting back though... Short TFNs are skin to skin in 5 to 8 minutes. Don't think anyone can do a Gamma Nail in that short of time.
     
  20. Anonymous

    Anonymous Guest

    Question!!!

    I broke my hip and it was repaired with a rod and tfn nail that went into my femur.
    Two days after the hip repair my femur cracked....right under the rod/tfn nail.
    The dr reports say it is due to the TFN nail.
    I am in my early 40's and have no health problems (no osteoporosis, etc)

    Any thoughts here???