Although many studies describe the endoprosthetic replacement as the safer method to treat pathologic femur fractures, our data showed that intramedullary stabilization and endoprosthetic replacement to be safe, and equivalent alternatives to treat complete pathologic fractures of the femur in patients with advanced metastatic disease.

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Our results suggest that injuries of the IOM are more frequent than generally expected. The findings support the conclusions of some of the previous cadaver studies. If IOM lesions are suspected, magnetic resonance imaging tomography should be performed.

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We performed a biomechanical study comparing two sutures (Ticron; Ethibond Exel) commonly used in flexor tendon surgery. With the use of a custom-made tensile tester ultimate load to failure testing with and without cyclic preloading was performed. The median breaking strength of the Ticron suture was 28 N without and 27.4 N with cyclic preloading, for the Ethibond Exel suture 33 N without and 34 N with cyclic preloading. The mean elongation after cyclic preloading was 3.3 mm for the Ticron suture and 4.5 mm for the Ethibond Exel suture, respectively. On the basis of these data, recommendations are made on the use of the Ethibond Exel suture for flexor tendon surgery.

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