Prophylactic and therapeutic fixation of weight-bearing long bones with metastatic cancer.

摘要

BACKGROUND: We retrospectively studied the duration of operations and the hospitalizations for impending and manifest fractures of weight-bearing long bones with metastatic disease, which has rarely been done. METHODS: The duration of operative fixation and the hospital stay in patients with an impending (n = 7) or actual (n = 15) fracture in a weight-bearing long bone with metastatic tumor were assessed, including symptomatic response, posttreatment mobility, and survival rate. RESULTS: Most patients had significant relief of pain. More than half of patients with impending fracture and 80% with actual fracture were ambulatory after therapy; 3-year survival rates were 29% and 13%, respectively. Corresponding mean durations for the operations were 175 minutes and 185 minutes, respectively; mean durations of hospitalization were 22 days and 16 days, respectively. CONCLUSION: Surgical fixation of fractures in weight-bearing long bones with metastatic cancer does not require excessive operative time as compared with that of impending fractures, does not extend hospitalization, and has an acceptable risk-reward ratio.