Surgical Treatment of Pathological Fractures Occurring at the Proximal Femur.
10.3349/ymj.2015.56.2.460
- Author:
Won Sik CHOY
1
;
Kap Jung KIM
;
Sang Ki LEE
;
Dae Suk YANG
;
Sang Wook JEUNG
;
Han Gyul CHOI
;
Hyun Jong PARK
Author Information
1. Department of Orthopaedic Surgery, Eulji University College of Medicine, Daejeon, Korea. oskkj@eulji.ac.kr
- Publication Type:Original Article
- Keywords:
Proximal femur;
pathological fracture;
intramedullary nailing;
joint replacement surgery
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Bone Nails;
Bone Neoplasms/*secondary/surgery;
Female;
Femoral Fractures/etiology/pathology/*surgery;
Fracture Fixation, Intramedullary/*methods;
Fracture Healing;
Fractures, Spontaneous/pathology/*surgery;
Hip Fractures/surgery;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Neoplasm Recurrence, Local/surgery;
Neoplasms/complications/pathology/*surgery;
Postoperative Complications;
Quality of Life;
Survival Rate;
Treatment Outcome
- From:Yonsei Medical Journal
2015;56(2):460-465
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To analyze the results of surgical treatment for pathological fractures at the proximal femur. MATERIALS AND 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. CONCLUSION: 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.
