Percutaneous osteosynthesis and cementoplasty for stabilization of malignant pathologic fractures of the proximal femur - 30/05/17
Abstract |
Purpose |
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.
Materials and 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.
Conclusion |
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.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Preventive percutaneous osteosynthesis, Pathological fracture, Cementoplasty, Metastatic bone disease, Interventional radiology
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Vol 98 - N° 6
P. 483-489 - Giugno 2017 Ritorno al numeroBenvenuto su EM|consulte, il riferimento dei professionisti della salute.