Surgical treatment of metastatic fractures of the femur: a retrospective analysis of 142 patients.
BACKGROUND
Pathologic fractures of long bones are common complications of the metastatic disease; however, the influence of the primary tumor, the stage of metastatic disease, different surgical techniques, and the postoperative mobility on the postoperative survival has not been clearly defined. The aim of this retrospective study was to evaluate outcome after surgical treatment for pathologic femur fractures.


METHODS
A consecutive series of 142 patients with metastatic fractures of femur were retrospectively studied. The operative treatment was based on intramedullary fixation (n = 94), gliding screws (n = 15), other extramedullary fixation devices (n = 7), and arthroplasty (n = 23).


RESULTS
Seventeen percent and 6% of the patients survived 1 year and 2 years, respectively, postoperatively. Postoperative survival was higher in patients with pathologic femur fractures because of breast carcinoma than in patients with other primary tumors. The rate of complications for patients with intramedullary stabilization, gliding screw fixation, and endoprosthetic replacement was 3.2%, 20%, and 8.6%, respectively.


CONCLUSIONS
Although many studies describe the endoprosthetic replacement as the safer method to treat pathologic femur fractures, our data showed that intramedullary stabilization and endoprosthetic replacement to be safe, and equivalent alternatives to treat complete pathologic fractures of the femur in patients with advanced metastatic disease.
Department of Traumatology, Medical University of Vienna, Vienna General Hospital, Währingergürtel, Vienna, Austria. kambiz.sarahrudi@meduniwien.ac.at
Kambiz
K
Sarahrudi
Manfred
M
Greitbauer
Patrick
P
Platzer
Jan-Till
JT
Hausmann
Thomas
T
Heinz
Vilmos
V
Vécsei
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000150:complications* / Q000556:secondary*; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology; D001984:Bronchial Neoplasms / Q000473:pathology; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D005593:Fracture Fixation, Internal; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies