A gamma nail has been used to treat intertrochanteric fractures since 1988. Although such cephalomedullary nails have mechanical advantages over extramedullary fixation devices, such as sliding hip screw, their beneficial effects on treating the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 fractures are still controversial. During their 30- year history, many problems have been overcome, and new types of cephalomedullary nails have been introduced in clinical practice. New cephalomedullary nail systems facilitate nailing procedures and enhance the purchase capability of the femoral head by a lag screw. On the other hand, the failure rate still depends on the hands of the orthopedic surgeons. This review article focused on the basic principle of medial support and restoration of a medial buttress during the treatment of trochanteric fractures using a cephalomedullary nail.

The purpose of this study was to evaluate feasibility of Vertical Multileaf Collimator for determination of irradiation size using Vertical Multileaf Collimator and lead block to determine 4 different irradiation shape in case of Co-60 gamma-ray and 6 MV X-ray. We chose ion chamber, glass dosimeter and EBT chromic film to compare with Vertical Multileaf Collimator results and lead block results. In case of Co-60 gamma-ray and 6 MV X-ray, the central axis point dose normalized at reference field of lead block with ion chamber results for Vertical Multileaf Collimator were estimated higher than lead block about 5.1%, 4.2%. In case of Co-60 gamma-ray, the central axis point dose normalized at reference field of lead block with glass dosimeter results for Vertical Multileaf Collimator were estimated higher than lead block about 2.2%, 7.8%, 7.2%, 4.0% for reference, circle, triangle, cross field, respectively. In case of 6 MV X-ray, the central axis point dose normalized at reference field of lead block with glass dosimeter results for Vertical Multileaf Collimator were estimated higher than lead block about 6.7%, 6.2%, 3.8%, 6.2% for reference, circle, triangle, cross field, respectively. The results of EBT chromic film, Vertical Multileaf Collimator of penumbra size for all irradiation shape was smaller than lead block of those size that 2.0~3.5 mm for Co-60 gamma-ray, 0.5~1.0 mm for 6 MV X-ray. The results from this study, radiation treatment volume that results in shielding block can be minimized. In addition, during radiation treatment for 2, 3-dimensional radiation therapy using a Vertical Multileaf Collimator of this survey can be used to determine variety of irradiation fields.
Axis, Cervical Vertebra ; Feasibility Studies ; Glass