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Erschienen in: International Orthopaedics 10/2017

02.08.2017 | Original Paper

Case series of patients with pathological dyaphiseal fractures from metastatic bone disease

verfasst von: Dinu Vermesan, Radu Prejbeanu, Horia Haragus, Alis Dema, Manuel D. Oprea, Diana Andrei, Dan V. Poenaru, Marius Niculescu

Erschienen in: International Orthopaedics | Ausgabe 10/2017

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Abstract

Introduction

Fractures on pathologic bone have major impact on life quality. The appropriate treatment is not standardized, but the current literature delineates that surgery must provide adequate stabilization for the life expectancy. We aimed to review the epidemiology, treatment outcomes and survival in our department.

Material and methods

The electronic database from a major referral centre was searched for patients treated for tumours and fractures by the corresponding ICM-10 codes over five years. Eighty-nine patients were identified. Eleven females and nine males, with an average age of 64 years underwent 23 operations during the selected timeframe. Six fractures were subtrochanteric, five at the femoral neck and five at the femoral diaphysis. Seventeen cases were metastatic carcinomas, out of which five mammary, three pulmonary and seven carcinomas of undetermined origin without immunohistochemistry.

Results

Fourteen types of surgical intervention were osteosynthesis with intramedullary nails and six were partial hip replacements of which one had proximal femur resection and revision stem hemiarthroplasty. Four patients had single metastatic lesions which underwent resection and defect filling using PMMA cement (polymethylmethacrylate). The follow-up period ranged between two and seven years or until death. Only five patients (25%) were alive at the last follow-up. Local recurrence appeared in one patient. There was one immediate post-operative complication (dehiscent wound) and one implant failure after five years and was replaced with a larger diameter (exchange nailing).

Conclusion

Both hip arthroplasty and femoral nailing are safe and routine procedures that are performed with relatively technical ease and low surgical stress and few peri-operative complications for the patient. They allow for immediate mobilization and weight-bearing with moderate and rapidly decreasing pain and discomfort.
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Metadaten
Titel
Case series of patients with pathological dyaphiseal fractures from metastatic bone disease
verfasst von
Dinu Vermesan
Radu Prejbeanu
Horia Haragus
Alis Dema
Manuel D. Oprea
Diana Andrei
Dan V. Poenaru
Marius Niculescu
Publikationsdatum
02.08.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 10/2017
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3582-3

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