Intramedullary Nailing for Pathological Femoral Fractures

Sharma, Hemant; Bhagat, Shaishav; McCaul, Jeannie; MacDonald, David; Rana, B; Naik, M

doi:10.1177/230949900701500309

Cited by 27 publications

(22 citation statements)

References 12 publications

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“…Allograft reconstructions and plate and screw fixation are not recommended in patients with metastatic bone disease because they require too long to heal, have too many early complications, and add to the complexity of subsequent procedures if metastatic progression occurs 4, 29, 30. Reconstruction‐type, interlocking hip or femoral nails are recommended for femoral pathological fractures, provided that the fracture could be stabilized satisfactorily 4, 20. Closed nailing is usually adequate, except if curettage and cementation of a large cortical defect is to be treated 4.…”

Section: Discussionmentioning

confidence: 99%

Survival analysis of patients with femoral metastases

Mavrogenis

Pala

Romagnoli

et al. 2011

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Survival analysis of patients with femoral metastases

Mavrogenis

Pala

Romagnoli

et al. 2011

Journal of Surgical Oncology

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“…We observed slightly greater survival rate in our study: 87% of patients survived 89.1 months after surgery. Results of other study demonstrated (15) that postoperative survival rate was did not depend on extent and time of surgery and mostly depended on morphological type of cancer. Considering this, all data should be considered critically.…”

Section: Discussionmentioning

confidence: 93%

Surgical treatment of metastatic tumors of the femur

Toliušis¹,

Kalesinskas²,

Kiudelis³

et al. 2010

Medicina

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Objective. To evaluate the patients functional outcome and pain control after resection of metastatic femoral tumors. Material and methods. A prospective randomized clinical study was conducted, which included 26 cases of metastatic tumors of the femur with an associated pathologic fracture. These selected cases were randomly divided into two groups based upon the using of methylmethacrylate cement in fracture fixation. Group 1 (n=13) included all cases where the fractures were treated with bone cement augmentation. Group 2 (n=13) included all cases where the fractures were treated without bone cement augmentation. Functional outcome was evaluated according the American Musculoskeletal Tumor Society system. Results. Good and excellent pain control was achieved in 61.5%, satisfactory in 38.5% of all cases in the Group 1 versus 15.5% (P=0.015) and 69% (χ2=2.4762; P=0.115) of all cases in the Group 2. Functional outcome after femoral metastasis resection and pathologic fracture fixation was significantly better in the Group 1. Total lower extremity function of full normal function was 67% in the Group 1 versus 49% in the Group 2 (P<0.05). We did not observe significant difference between patients’ postoperative survival in the groups (P>0.05). The postoperative durability of stable pathologic fracture fixation was shorter in the Group 2 (273.9±51.7 vs. 358.9±116.8 days) comparing with Group 1 (P=0.03). Conclusions. The introduction of bone cement as the adjunct to the pathologic femoral fracture fixation significantly improved the clinical our study results: we achieved better functional outcome and better pain control.

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“…Bone metastasis at the proximal femur is the third most common site after spine and pelvis [1]. Immediate xation or prosthetic replacement provides pain control, return to previous ambulatory status, improved psychological well-being, and improved quality of life [1][2][3][4][5]. Intramedullary nailing of long bones is an accepted technique for management of existing or impending pathological fracture, especially of the proximal femur.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of proximal femoral locking-plate fixation for pathological fractures of the proximal femur

Riansuwan

Jivasomboonkul

Phimolsarnti

et al. 2020

Preprint

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Background Intramedullary nailing of long bones is a common technique for management of existing or impending pathological fracture of the proximal femur. This fixation has been shown to be biomechanically superior to the locking-plate system. However, serious complications, including pulmonary embolism, have been reported in patients treated with intramedullary nailing with or without reaming. The purpose of this report was to study the treatment outcomes of proximal femoral locking-plate fixation of pathological fractures of the proximal femur relative to clinical results, implant failure, and surgical complications. Methods From 2007 to 2018, 17 patients (18 femurs) with a diagnosis of impending or existing pathological fracture of the proximal femur were treated with proximal femoral locking-plate fixation. Data collected included operative duration, estimated blood loss, ambulatory status, hardware failure events, and postoperative complications. Results Of the 18 femurs that were included, 13 were existing pathological fractures and 5 were impending fractures. The mean age of patients was 53.7 years (range: 28–89), and 12 of them were female. The mean follow-up was 11.3 months (range: 1–67). Ten of 17 patients (62.5%) had progressive lung disease from pulmonary metastasis or from lung primary. No patient developed oxygen desaturation or cardiac arrest during the intraoperative or postoperative period. Thirteen of 17 patients (76.5%) could walk with or without an assistive device at the time of final follow-up. Two patients required close postoperative monitoring in the ICU due to poor preoperative status, and both of those patients died within one month after surgery from other medical problems. No hardware failure occurred. Conclusion For pathological fracture of the proximal femur, proximal femoral locking-plate fixation is a treatment option that results in fewer perioperative and postoperative cardiopulmonary events and surgical complications. Most patients can ambulate with or without an assistive device at the final follow-up.

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Intramedullary Nailing for Pathological Femoral Fractures

Abstract: Intramedullary nailing appears safe and effective for treatment of metastatic bone disease, and confers good functional results, pain relief, and mobility.

Cited by 27 publications

References 12 publications

Survival analysis of patients with femoral metastases

Survival analysis of patients with femoral metastases

Surgical treatment of metastatic tumors of the femur

Outcomes of proximal femoral locking-plate fixation for pathological fractures of the proximal femur

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