Authors - Emsos 2016

Metastatic pathological fractures of the femur: treatment and outcomes
Abstract ID : 1501
Submitted by : Santos Sandra the 2016-02-22 23:06:13
Category : Others
Typology : Poster
Status : Validated
Authorisation to disclose : Yes/Oui
------------------------------------Introduction: Due to the advances in oncological therapy, the life expectancy of patients with malignant tumors, and
consequently the incidence of pathological fractures, has increased over the last decades. Pathological fractures of the
long bones are common complications of metastatic disease. The aim of this study was to evaluate the outcome after
surgical treatment of pathologic fractures of the femur with an intramedullary nail.
Materials /Patients and methods: We performed a retrospective review of patients treated for pathological femur fracture
in our department, from 1998 to 2014 (16 year-period). Demographical data, primary tumor distribution, treatment and
associated complications were reviewed.
Results: A total of 55 patients (32 female), with a mean age of 63 years (32–90) were identified and reviewed. Of these,
thirty were consummated pathological fractures, and the remaining were imminent fractures of the femur. In 58.5% (n=?)
of cases the fracture line was located to the proximal third of the femur. Breast cancer was the most common primary
tumor (n=27), followed by lung (n=9), prostate (n=7) and renal cancer (n=5). The treatment of choice was internal
fixation with intramedullary nailing; in 40 cases, stabilization was achieved with a long cephalomedullary nail, and in the
remaining 15 a standard intramedullary nail was used. In all cases, an unreamed and locked nail was used; in 8 patients,
enhanced fixation with PMMA (onde?) was performed. Most of the patients underwent adjuvant radiotherapy. There was
no mortality related to the surgical procedure, and no intra-operative complications occurred. Post-operative
complications reported (n=3) were related to failure of fixation.
Discussion and Conclusion: Early palliative and preventive treatment of pathological fractures of the femur is indicated in
most patients with advanced stage metastatic disease. Low complication rates, pain relief and early mobilization justify
surgical stabilization of fractures in this group of patients. Intramedullary nailing represents a valuable fixation method for
pathologic fractures or imminent fractures of the femur; it provides adequate stability to outlast the patient’s remaining
life expectancy, with better quality of life.
------------------------------------Keywords : Pathological Fracture, Metastatic Disease, Femur
Authors :
References : , , ,
Authors
Sandra Santos 1, Rúben Fonseca 1, Paulo Tavares 1, João Freitas 1, José Casanova 1,
1. Unidade de Tumores do Aparelho Locomotor, Centro Hospitalar e Universitário de Coimbra, Coimbra, PORTUGAL
Authors (raw format)
Santos Sandra - email : [email protected] Institution : Centro Hospitalar e Universitário de Coimbra
Department : Unidade de Tumores do Aparelho Locomotor City : Coimbra Country : PORTUGAL Speaker : Yes
Fonseca Rúben - email : [email protected] Institution : Centro Hospitalar e Universitário de Coimbra
Department : Unidade de Tumores do Aparelho Locomotor City : Coimbra Country : PORTUGAL Speaker : No
Tavares Paulo - email : [email protected] Institution : Centro Hospitalar e Universitário de Coimbra Department :
Unidade de Tumores do Aparelho Locomotor City : Coimbra Country : PORTUGAL Speaker : No
Freitas João - email : [email protected] Institution : Centro Hospitalar e Universitário de Coimbra
Department : Unidade de Tumores do Aparelho Locomotor City : Coimbra Country : PORTUGAL Speaker : No
Casanova José - email : [email protected] Institution : Centro Hospitalar e Universitário de Coimbra
Department : Unidade de Tumores do Aparelho Locomotor City : Coimbra Country : PORTUGAL Speaker : No