title: Surgical fixation of pathologic fractures: an evaluation of evolving treatment methods.
abstract: The surgical techniques for the fixation of pathologic fractures continue to evolve. The present study examines clinical outcomes and complications associated with the use of newer generation interlocked intramedullary nails compared with open reduction and internal fixation with plates and screws for pathologic fractures in long bones. Fifty operative procedures performed on 37 patients by five community orthopaedic surgeons were retrospectively reviewed. The operative procedures were separated into two groups based upon the method of fracture fixation; the groups were compared for differences in hardware or fixation failure. The use of intramedullary devices was associated with a significantly lower number of hardware or fixation failures (p < 0.02). This data, in addition to several additional advantages of indirect reduction and intramedullary fixation of pathologic fractures, supports this method of fracture care over open reduction and internal fixation in appropriate cases.
authors.affiliation: Sarcoma Service, Department of Orthopedics, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Suite 2100, Salt Lake City, Utah 84112, USA.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Hunt
authors.forename: Sohrab
authors.initials: S
authors.lastname: Gollogly
authors.forename: R Lor
authors.initials: RL
authors.lastname: Randall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements; D005260:Female; D005269:Femur / Q000293:injuries*; D005593:Fracture Fixation, Internal / Q000379:methods*; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006811:Humerus / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D019904:Polymethyl Methacrylate; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate