Surgical Treatment of Four Patients with Pathological Fracture of the Proximal Femur.

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Recently, surgery has been actively conducted in many patients for treatment of pathological fractures resulting from metastases of malignant tumors. There are two operative methods; the first is a palliative approach where osteosynthesis is performed without excising the metastatic lesion, and the second is a radical approach where the metastatic lesion is actively resected and osteoplasty is done. From January 1989 till December 1994, we performed palliative surgery in four patients with pathological fractures of the proximal femur resulting from bone metastases of malignant tumors. After internal resection of the tumor (or intratumoral resection), fixation was done using AO condylar plate. There is no general consensus regarding the choice between the palliative or radical approach. Nonetheless, on applying the preoperative severity determination criteria (developed by Tokubashi et al.) for pathological fractures of the long bones caused by metastatic bone tumors on the patients of the present report, a good matching was observed. Consequently, we think that these criteria may be used fin the preoperative assessment of the patients.Concerning the postoperative results, the quality of life (QOL) of the four patients of the present report improved.
中国・四国整形外科学会の論文