title: The incidence of acute cardiorespiratory and vascular dysfunction following intramedullary nail fixation of femoral metastasis.
abstract: Intramedullary nail fixation is a common treatment for metastatic tumors of the femur with overt or impending femoral fracture. This procedure sometimes causes severe cardiorespiratory and vascular dysfunction. The clinical relevance of this is not dear. We reviewed 45 operations in 43 patients, where intramedullary nail fixation was used to treat metastatic femoral fractures and impending fractures. We studied the incidence of intraoperative oxygen desaturation and hypotension associated with intramedullary manipulation as markers of cardiorespiratory and vascular dysfunction. Acute oxygen desaturation and hypotension occurred in 11 of our 45 patients. Of these, 3 died, 2 required intensive care postoperatively and 6 made uneventful recoveries. We hope to highlight a serious complication in this patient group.
authors.affiliation: Department of Orthopaedics, St. Vincent's Public Hospital, Fitzroy, Victoria, Australia.
authors.forename: S A
authors.initials: SA
authors.lastname: Barwood
authors.forename: J L
authors.initials: JL
authors.lastname: Wilson
authors.forename: R R
authors.initials: RR
authors.lastname: Molnar
authors.forename: P F
authors.initials: PF
authors.lastname: Choong
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000009:adverse effects; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D005266:Femoral Neoplasms / Q000150:complications* / Q000556:secondary*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000379:methods; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007022:Hypotension / Q000209:etiology* / Q000401:mortality; D000860:Hypoxia / Q000209:etiology* / Q000401:mortality; D015994:Incidence; D007431:Intraoperative Complications / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011859:Radiography; D012189:Retrospective Studies; D013577:Syndrome
chemical_list: D001843:Bone Cements