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Long bone shaft metastasis: a comparative study between cement filling and intercalary prosthesis
Yichao Fan1, Boya Zhang1, Liangyv Guo1
1Department of Bone and Soft Tissue Cancer, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, No. 127 Dongming Road, Zhengzhou, 450008, China.
World Journal of Surgical Oncology
|December 1, 2023
Summary
Custom intercalary prostheses offer a more effective limb reconstruction for bone metastases, showing fewer complications and less blood loss compared to cement and fixation. This approach improves patient outcomes in extremity bone cancer management.
Area of Science:
- Orthopedic Oncology
- Surgical Reconstruction
- Metastatic Bone Disease
Background:
- Metastatic bone lesions in extremities cause severe pain and fractures, impacting quality of life.
- Effective management of long bone metastases is crucial for patient outcomes and treatment options.
Purpose of the Study:
- To compare the efficacy and complications of two surgical reconstruction techniques for long bone metastases.
- To identify a more effective limb reconstruction approach for these lesions.
Main Methods:
- Retrospective study of 28 patients with extremity long bone metastases (Jan 2017 - June 2022).
- Group 1: Curettage, cement filling, and internal fixation (plates/nails).
- Group 2: Complete resection and custom intercalary prosthesis replacement.
Main Results:
- No significant differences in patient demographics or operative times between groups.
- Group 2 (prostheses) had significantly less intraoperative blood loss (521 ml vs 769 ml).
- Group 2 showed a lower complication rate (15% vs 33%), including fewer internal fixation failures and tumor recurrences.
Conclusions:
- Both techniques are effective for long bone metastases.
- Custom intercalary prostheses (Group 2) demonstrate reduced complications and blood loss.
- Prosthetic reconstruction may be a superior approach for limb salvage in these cases.
