title: Survival after pathological fractures of the proximal femur.
abstract: We report on the survival of 145 patients presenting to a single centre with a pathological metastatic fracture of the proximal femur. The single surviving patient had a follow-up of 17.7 years. Mean survival for the 144 patients who died was 332 days (range 2 to 3053 days), being longest for those with myeloma (662 days), lymphoma (> 633 days) and breast tumours (477 days) and lowest for lung tumours (110 days). The most common sites for the primary tumour were breast (36%), prostate (23%) and lung (17%). 47% of fractures were intracapsular, 28% trochanteric and 25% subtrochanteric. 99% of the fractures were treated surgically with a mean hospital stay of 19 days. The commonest fracture healing complication was further fracture of the femur around or immediately below the implant which occurred after 9/144 (6.2%) of operations. The difference in survival of patients related to the primary tumour site is of relevance in planning surgical treatment and discussing prognosis with patients.
authors.affiliation: Department of Orthopaedics, Peterborough City Hospital, Peterborough, UK. Martyn.Parker@pbh-tr.nhs.uk
authors.forename: Martyn J
authors.initials: MJ
authors.lastname: Parker
authors.forename: Asif Z
authors.initials: AZ
authors.lastname: Khan
authors.forename: Tom K
authors.initials: TK
authors.lastname: Rowlands
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000150:complications / Q000401:mortality / Q000556:secondary*; D005260:Female; D017102:Fracture Healing; D005598:Fractures, Spontaneous / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D006620:Hip Fractures / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D006621:Hip Joint / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology