Surgical Treatment of Metastatic Bone Disease around the Proximal Femur

黃德揚(Te-Yang Huang) ； 黃俊雄(Chun-Hsiung Huang) ； 蘇榮源(Jung-Yuan Su)

《Journal of Orthopaedic Surgery Taiwan》 17卷1期 (2000/03) Pp. 41-55

並列摘要

Form 1987 to 1998, 41 patients (30 pathological fractures and 11 impending fractures) were operated for metastatic proximal femoral lesions, 21 females and 20 males, with an average age of 58 years at surgery. Carcinomas of breast, lung, prostate and uterine cervix were the most common primary tumors. The distribution of metastatic lesions was 8 in femoral head and neck, 4 in intertrochanteric area, 16 in subtrochanteric area, 5 in femoral neck and intertrochanteric areas, 2 in intertrochanteric and subrochanteric areas, and 6 in the entire proximal end of femur, extended from femoral neck down to subtrochanteric area. The applied implant devices were 12 sliding hip screw and plates, 11 intramedullary nails, 8 bipolar hip endoprostheses, and 10 megapros-theses. Bone cement augmentation for filling the pathological defect or fixing the prosthetic stem was performed in 34 patients. Segmental resection of metastatic lesion, the average length was 12.4cm, was done for 17 cases. The mean follow-up period for still alive patients was 29 months and for died patients was 10 months. 27 cases (66%) got satisfactory pain relief postoperatively. The 5 patients survived less than 2 months postoperatively were excluded, 10 (91%) of impending fracture cases had significant ambulatory function improvement and 23 (92%) of fractured cases could get out of bed or keep on ambulating. Fixation failure was the most common complication, and 3 revision surgeries had been carried out. It was concluded that the safe enough reconstructing or stabilizing surgery could increase the life quality of the patients who had metastatic proximal femoral lesion.

並列關鍵字

Metstasis ； Femur ； Fixation ； Prosthesis