Operative management of impending pathological fractures: A critical analysis of therapy

Geffen, E. van; Wobbes, Theo; Veth, R.P.H.; Gelderman, Willem A. H.

doi:10.1002/(sici)1096-9098(199703)64:3<190::aid-jso3>3.0.co;2-5

Cited by 26 publications

(19 citation statements)

References 18 publications

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“…Similarly elevated functional recovery rates after surgical stabilization were reported by van Geffen et al. [9]. The difference in outcomes seems to depend on patient selection for adjuvant RT.…”

Section: Discussionmentioning

confidence: 99%

“…[16] published a systematic review of literature on postoperative irradiation after surgical bone stabilization. The review was based on two articles [3, 9] and identified 64 and 110 patients of whom 55% and 28% received postoperative RT, respectively. They concluded that the current available literature might be insufficient to decide whether postoperative RT after surgical stabilization should be standard care.…”

Section: Discussionmentioning

confidence: 99%

“…The observed proportion of patients reaching normal FS (± pain) at any time was 53% for the group having surgery plus postoperative RT versus 11.5% for the surgery-only group. The later published studies examined the number of surgical reinterventions and complications [9, 10]. The functional outcome has not been investigated since then.…”

Section: Introductionmentioning

confidence: 99%

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Functional recovery after surgical stabilization and postoperative radiotherapy due to metastases of long bones

Adamietz

Wolańczyk

2018

Strahlenther Onkol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Functional recovery after surgical stabilization and postoperative radiotherapy due to metastases of long bones

Adamietz

Wolańczyk

2018

Strahlenther Onkol

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“…However, it leaves the femoral neck region unprotected against pathological fractures from existing or future metastases [13,15]. Vander Hurst et al reported 18% incidence of femoral neck fractures due to occult metastases following treatment with standard intramedullary nails [17].…”

Section: Pain Relief and Mobilitymentioning

confidence: 99%

Subtrochanteric metastatic lesions treated with the long gamma nail

Samsani

Panikkar

Georgiannos

et al. 2003

International Orthopaedics

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From 1996 to 2002, 39 consecutive intramedullary reconstructions (three bilateral) in 36 patients were performed in a group of subtrochanteric femoral metastatic bone disease using the long gamma nail (LGN). Reconstruction was performed prophylactically in 28 femurs and, for actual fractures in 11. All patients achieved good functional results with pain relief and improved mobility. No major intraoperative complication or long-term mechanical failures were observed. Minor technical, medical and implant related complications were seen in 14 patients. The LGN is a valuable intramedullary reconstruction device with good functional outcome for the treatment of subtrochanteric femoral metastatic bone disease.

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“…The consequences of pathological fracture in this area are significant so that prophylactic fixation prevents pathological complications [12,16].…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Fixation of Impending Fractures

Kornah¹,

Safwat²,

ghany³

2016

J Metabolic Synd

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Aim: Pathologic fractures occur as a result of weakening of the mechanical properties of bone. There are many conditions, which lead to bone softening. There are neoplastic and non-neoplastic diseases that cause pathologic fractures. The aim is to evaluate and to highlight on value of prophylactic fixation of impending fractures in abnormal bone situation to prevent occurrence of pathological fracture and its complications. Patients and methods:Between 2003 and 2009, study on forty-nine patient (35 females and 14 males) between the age of 20 and 65 years with an average age of 49.9 years with expected possibility of fractures of lower extremities. The entire patient with fractures risks prophylactic fixation has done. Different types of fixation either surface plating (dynamic hip screws), medullary (Gamma nails or locking nail) or external fixation in cases unsuitable for surgery was used according to the type and the site of the deformity in combination of management of primary condition.Results: Most patients had significant relief of pain. 35 (71.5%) of patients with impending fracture were ambulatory after therapy and able to walk outdoor while 10 (20.5%) of patients could walk inside door. Three patients (6%) using wheel chair, and they were on renal dialysis. Only one patient (2%) was not able to walk, and he was not cooperative for unknown reason. The mean duration of hospitalization was 21 days (range from 7 to 35 days). That time included preoperative period of investigation and preparation and post-operative surgery and rehabilitation.Discussion: Pathological fractures create a serious morbidity in patients with bone disease. Orthopedic surgeons who look after patients with skeletal lesions should focus on proactive treatments designed to prevent pathologic fractures before they occur. Prophylactic fixations have decreased morbidity compared with patient's sustained fractures before fixation. Conclusion:Surgical fixation of fractures in weight-bearing long bones with impending fractures provides pain relief, and a functionally stable and durable construct. It helps early an ambulation and prevents fracture's complication. It allows independent function and avoids irretrievable catastrophes.

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Operative management of impending pathological fractures: A critical analysis of therapy

Cited by 26 publications

References 18 publications

Functional recovery after surgical stabilization and postoperative radiotherapy due to metastases of long bones

Functional recovery after surgical stabilization and postoperative radiotherapy due to metastases of long bones

Subtrochanteric metastatic lesions treated with the long gamma nail

Prophylactic Fixation of Impending Fractures

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