title: Percutaneous osteosynthesis and cementoplasty for stabilization of malignant pathologic fractures of the proximal femur.
abstract: OBJECTIVE
  To retrospectively evaluate the outcome of patients who underwent radiological percutaneous osteosynthesis and cementoplasty (RPOC) for stabilization of malignant pathological fracture of the proximal femur.
  
  
  METHODS
  The clinical files of 12 patients who underwent RPOC for stabilization of malignant pathological fracture of the proximal femur were reviewed. There were 9 men and 3 women with a mean age of 56 years±13 (SD) (range: 35-82 years). All patients had metastases of proximal femur and a high fracture risk (Mirels score≥8) and were not eligible for surgical stabilization. The primary endpoint was the occurrence of a fracture after RPOC. Secondary endpoints were the procedure time, early complications of RPOC, pain reduction as assessed using a visual analog scale (VAS) and duration of hospital stay.
  
  
  RESULTS
  No patients treated with RPOC had a fracture during a mean follow-up time of 382 days±274 (SD) (range: 11-815 days). RPOC was performed under general (n=10) or locoregional (n=2) anesthesia. The average duration of the procedure was 95min±17 (SD) (range: 73-121min). The technical success rate was 100%. All patients were able to walk on the day following RPOC. The average duration of hospital stay was 4days ±3 (SD) (range: 2-10 days). No major complication occurred. One patient complained of hypoesthesia in the lateral thigh. For symptomatic patients (n=7), VAS score decreased from 6.8±1.2 (SD) (range: 5-9) before treatment, to 2.3±1.1 (SD) (range: 1-4) one month later.
  
  
  CONCLUSIONS
  Preventive RPOC for pathological fracture of the proximal femur is a reliable alternative for cancer patients who are not candidates for surgical stabilization. Studies involving more patients are needed to confirm our preliminary experience.
authors.affiliation: Department of Radiology, Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France. Electronic address: ertimavrovi@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Mavrovi
authors.affiliation: Department of Radiology, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France.
authors.forename: J-B
authors.initials: JB
authors.lastname: Pialat
authors.affiliation: Department of Radiology, Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France.
authors.forename: H
authors.initials: H
authors.lastname: Beji
authors.affiliation: Department of Radiology, Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France.
authors.forename: A-C
authors.initials: AC
authors.lastname: Kalenderian
authors.affiliation: Department of Oncologic Surgery, Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France.
authors.forename: G
authors.initials: G
authors.lastname: Vaz
authors.affiliation: Department of Radiology, Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France.
authors.forename: B
authors.initials: B
authors.lastname: Richioud
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060826:Cementoplasty; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005266:Femoral Neoplasms / Q000150:complications; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Cementoplasty; Interventional radiology; Metastatic bone disease; Pathological fracture; Preventive percutaneous osteosynthesis