Radiological and functional assessment of indications for operative treatment in patients with long bone metastases.
Background. The purpose of the study is to evaluate the risk of fractures in long bones with metastases based on intact cortical bone index (ICBI) and functional assessment.<br /> Material and methods. We evaluate radiograms of 36 (25 fractures) and 86 patients (56 fractures) with the upper and lower extremity metastases, respectively. We measured on radiograms intact cortical bone index (ICBI) using the schedule K-G/K-J x100%, where is K-shaft diameter, G-size of destruction, J-bone marrow diameter above or below the metastases. We asses the extremity function by the ability to elevate and abduct it straight. <br /> Results. We found that fracture occurs if the ICBI is lower than 46% and 40% in upper and lower extremity, respectively. 7 (5,7%) patients develop fracture despite higher ICBI. If the metastases are located in upper part of the femur and humerus and he/she can not elevate or abduct the extremity the fracture inevitably occurs.<br /> Conclusions. Counting the ICBI and simple functional assessment allows to predict fracture in 94,3% of patients with long bone metastases.
Mazurkiewicz
Tomasz
T
Katedra i Klinika Ortopedii, Traumatologii i Rehabilitacji, Akademia Medyczna, Lublin.
Mazurkiewicz
Maria
M