title: Surgical treatment of pathological fractures occurring at the proximal femur.
abstract: OBJECTIVE
  To analyze the results of surgical treatment for pathological fractures at the proximal femur.
  
  
  METHODS
  Nineteen patients with a pathological fracture were included. The mean age was 65.7 years old. The patients comprised 8 males and 11 females. Primary tumors, types of pathological fractures, surgical procedures, and postoperative complications were recorded. Musculoskeletal Tumor Society (MSTS) functional score was used for functional evaluation. A Kaplan-Meier survival analysis was used to determine survival rate.
  
  
  RESULTS
  The primary malignancies were 6 cases of breast cancer, 3 cases of lung cancer, 3 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of hepatocellular carcinoma, 1 case of esophageal cancer, 1 case of colon cancer, and 1 case of ovarian cancer. Pathological fractures included 8 cases of pertrochanteric fractures and 11 cases of subtrochanteric fractures. Intramedullary nailing was performed in 10 cases, and joint replacement surgery was performed in 9 cases. Postoperative complications included local recurrence in 1 case, infection in 1 case, and nail breakage in 1 case. The mean postoperative MSTS score was 21. The mean survival period was 10.6 months. Patient survival rates were 42.1% after 6 months, 26.3% after 12 months, and 10.5% after 24 months.
  
  
  CONCLUSIONS
  Surgical treatment of pathological fractures at the proximal femur provided early ambulation, and excellent pain relief. The surgery was well tolerated emotionally. Surgery is necessary for improving the quality of life in such patients; however, more cases of pathological fractures in these regions should be subjected to detailed analysis.
authors: Department of Orthopaedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
authors: Won-Sik
authors: WS
authors: Choy
authors: Department of Orthopaedic Surgery, Eulji University College of Medicine, Daejeon, Korea. oskkj@eulji.ac.kr.
authors: Kap Jung
authors: KJ
authors: Kim
authors: Department of Orthopaedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
authors: Sang Ki
authors: SK
authors: Lee
authors: Department of Orthopaedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
authors: Dae Suk
authors: DS
authors: Yang
authors: Department of Orthopaedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
authors: Sang Wook
authors: SW
authors: Jeung
authors: Department of Orthopaedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
authors: Han Gyul
authors: HG
authors: Choi
authors: Department of Orthopaedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
authors: Hyun Jong
authors: HJ
authors: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001859:Bone Neoplasms / Q000556:secondary* / Q000601:surgery; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D005598:Fractures, Spontaneous / Q000473:pathology / Q000601:surgery*; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009369:Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011788:Quality of Life; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Proximal femur; intramedullary nailing; joint replacement surgery; pathological fracture