PDF(Pubmed)
Abstract：
OBJECTIVE: Pathologic fractures of the extremities due to carcinoma metastases require individual and patient prognosis-related stabilization procedures. Quick remobilization of the patient to restore the quality of life is of high importance, especially in the case of subtrochanteric and diaphyseal femoral fractures. In our retrospective cohort study, we evaluated intraoperative blood loss, length of operation, complication rate, and regain of lower extremity function in plate compound osteosynthesis (PCO) versus intramedullary nailing (IM) for subtrochanteric and diaphyseal pathologic fractures of the femur.
METHODS: Between January 2010 and July 2021, we retrospectively reviewed 49 patients who were treated at our institution for pathologic fractures of the subtrochanteric and diaphyseal femurs for group differences in terms of blood loss, length of operation, implant survival, and Musculoskeletal Tumor Society (MSTS) score.
RESULTS: We included 49 stabilization procedures of the lower extremity due to pathologic fractures of the proximal or diaphyseal femur, with a mean follow-up of 17.7 months. IM (n = 29) had a significantly shorter operation time than PCO (n = 20) (112.4 ± 9.4 and 163.3 ± 15.96 min, respectively). We did not detect any significant differences in terms of blood loss, complication rate, implant survival, or MSTS score.
CONCLUSIONS: Based on our data, pathologic subtrochanteric and diaphyseal fractures of the femur can be stabilized with IM, which has a shorter operation time than PCO, but the complication rate, implant survival, and blood loss remain unaffected.
METHODS: Between January 2010 and July 2021, we retrospectively reviewed 49 patients who were treated at our institution for pathologic fractures of the subtrochanteric and diaphyseal femurs for group differences in terms of blood loss, length of operation, implant survival, and Musculoskeletal Tumor Society (MSTS) score.
RESULTS: We included 49 stabilization procedures of the lower extremity due to pathologic fractures of the proximal or diaphyseal femur, with a mean follow-up of 17.7 months. IM (n = 29) had a significantly shorter operation time than PCO (n = 20) (112.4 ± 9.4 and 163.3 ± 15.96 min, respectively). We did not detect any significant differences in terms of blood loss, complication rate, implant survival, or MSTS score.
CONCLUSIONS: Based on our data, pathologic subtrochanteric and diaphyseal fractures of the femur can be stabilized with IM, which has a shorter operation time than PCO, but the complication rate, implant survival, and blood loss remain unaffected.
摘要：
目的：由于癌转移导致的四肢病理性骨折需要个体和患者预后相关的稳定程序。快速重新动员患者以恢复生活质量非常重要，特别是在股骨转子下和骨干股骨干骨折的情况下。在我们的回顾性队列研究中，我们评估了术中失血量,操作长度,并发症发生率,股骨转子下和骨干病理性骨折的钢板复合骨固定（PCO）与髓内钉（IM）的下肢功能恢复。
方法：在2010年1月至2021年7月之间，我们回顾性分析了在我们机构接受治疗的49例股骨粗隆下和股骨骨干部病理性骨折患者在失血方面的组间差异，操作长度,植入物存活，肌肉骨骼肿瘤协会（MSTS）评分。
结果：我们包括49例由于股骨近端或骨干的病理性骨折引起的下肢稳定手术，平均随访17.7个月。IM（n=29）的手术时间明显短于PCO（n=20）（112.4±9.4和163.3±15.96分钟，分别)。我们在失血方面没有发现任何显著差异，并发症发生率,植入物存活，或MSTS得分。
结论：根据我们的数据，股骨粗隆下和骨干骨折的病理性骨折可以用IM稳定，它的运行时间比PCO短，但是并发症的发生率，植入物存活，失血不受影响。
方法：在2010年1月至2021年7月之间，我们回顾性分析了在我们机构接受治疗的49例股骨粗隆下和股骨骨干部病理性骨折患者在失血方面的组间差异，操作长度,植入物存活，肌肉骨骼肿瘤协会（MSTS）评分。
结果：我们包括49例由于股骨近端或骨干的病理性骨折引起的下肢稳定手术，平均随访17.7个月。IM（n=29）的手术时间明显短于PCO（n=20）（112.4±9.4和163.3±15.96分钟，分别)。我们在失血方面没有发现任何显著差异，并发症发生率,植入物存活，或MSTS得分。
结论：根据我们的数据，股骨粗隆下和骨干骨折的病理性骨折可以用IM稳定，它的运行时间比PCO短，但是并发症的发生率，植入物存活，失血不受影响。
