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. 2006 Dec;30(6):519-24.
doi: 10.1007/s00264-006-0205-9. Epub 2006 Aug 30.

Treatment results of pathological fractures of the long bones: a retrospective analysis of 88 patients

Kambiz Sarahrudi  1 , Katherina Hora, Thomas Heinz, Steven Millington, Vilmos Vécsei
Affiliations

Treatment results of pathological fractures of the long bones: a retrospective analysis of 88 patients

Kambiz Sarahrudi et al. Int Orthop. 2006 Dec.

Abstract
in English, French

Due to the advances in oncological therapy, the life expectancy of patients with malignant tumours and the incidence of pathological fractures have increased over the last decades. Pathological fractures of the long bones are common complications of metastatic disease; however, the outcome of different surgical techniques for the treatment of these fractures has not been clearly defined. The aim of this study was to evaluate differences in patient's survival and postoperative complications after the treatment of pathological fractures of the long bones. Eighty-eight patients with 96 pathological fractures of the long bones were analysed retrospectively. Seventy-five patients with 83 fractures received surgical treatment. The operative treatments used were intramedullary fixation, gliding screws, plate osteosynthesis or arthroplasty. Five patients were still alive at the end of data collection at a median time of 42.5 months, and 16.2% survived 1 year, 7% 2 years and 4% more than 3 years postoperatively. All surgically treated patients had a reduction of local pain and were able to walk after the operation. The overall rate of complications was 8%. Early palliative treatment of pathological fractures of the long bones is indicated in most patients in the advanced stage of metastatic disease. The low complication rate, reduction of local pain and early mobilisation justify the surgical stabilisation of fractures in this cohort of patients.

En raison des progrés des thérapies oncologiques l’espérance de vie et la fréquences des fractures pathologiques ont augmentées chez les patients porteurs de tumeurs malignes. Les fractures pathologiques des os long sont une complication de la maladie métastatique et l’efficacité des différentes techniques de traitement chirurgical ne sont pas clairement définies. Le but de cette étude était d’évaluer les différences en terme de survie et de complications selon le traitement. C’est une étude rétrospective de 88 patients avec 96 fractures pathologiques traitées par clou centro-médullaire, vissage, plaque vissée ou arthroplasty. Cinq patients étaient encore en vie à la fin de l’étude avec une médiane de 42,5 mois; 16,2, 7 et 4% avaient survécu respectivement 1, 2 ou 3 ans ou plus. Tous les patients traités chirurgicalement avaient des capacités de déambulation et une réduction de leurs douleurs après l’opération. Le taux global de complications était de 8%. Le traitement palliatif précoce des fractures pathologiques des os longs est indiqué chez la plupart des patients à un stade avancé de la maladie métastatique. Le faible taux de complications, la réduction des douleurs et la mobilisation précoce justifient la stabilisation chirurgicale chez ces patients.

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Figures

Fig. 1
Fig. 1
Survival curves of all patients with pathological fracture of the long bone
Fig. 2
Fig. 2
Survival curves for patients with fracture of the femur and fracture of the humerus
See this image and copyright information in PMC

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