title: Use of cryoablation and osteoplasty reinforced with Kirschner wires in the treatment of femoral metastasis.
abstract: OBJECTIVE
  We report the case of a 43-year-old man with metastatic breast carcinoma to the proximal right femur resulting in severe painful pathological fracture. The patient experienced severe pain despite large doses of analgesia, resulting in impaired functionality and quality of life. The patient had significant comorbidities, making him a high surgical risk.
  
  
  METHODS
  The patient was treated with cryoablation and osteoplasty, followed by a novel technique consisting of osteoplasty reinforced with bone marrow Kirschner wires (K-wires) which will be described in details in this report.
  
  
  RESULTS
  The patient reported significant pain relief after the procedure, and gained right lower extremity functionality, as compared to total immobility before the procedure.
  
  
  CONCLUSIONS
  Our technique offers an alternative feasible treatment for patients at high surgical risk with pathological fractures in weight-bearing bones, in which osteoplasty alone has a high risk of cement leakage, inadequate fracture reduction, and early refracture. To our knowledge, our technique has not been previously described.
authors.affiliation: Department of Radiology, University of Alabama, Birmingham, AL 35249, USA. akamel@uabmc.edu
authors.forename: Ahmed Kamel
authors.initials: AK
authors.lastname: Abdel-Aal
authors.forename: Edgar S
authors.initials: ES
authors.lastname: Underwood
authors.forename: Souheil
authors.initials: S
authors.lastname: Saddekni
mesh_terms: D000328:Adult; D001864:Bone Wires; D018567:Breast Neoplasms, Male / Q000473:pathology*; D003131:Combined Modality Therapy; D003452:Cryosurgery; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000628:therapy*; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011788:Quality of Life; D014057:Tomography, X-Ray Computed