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Surgical treatment of metastatic tumors of the long bones
1Section of Orthopaedic Surgery, Taichung Veterans General Hospital, Taiwan, R.O.C.
Background:
With improvements in chemotherapy, endocrine therapy and radiotherapy, the development of a pathological fracture does not indicate a terminal stage for a neoplasm patient, since survival rates have increased over the years. A review has been undertaken of thirty-nine cases of long-bone metastases treated surgically at Taichung Veterans General Hospital in the past 11 years.
Methods:
Pathological fractures and impending fractures were managed with open reduction and internal fixation with different methods, dependent upon the lesion site. Methylmethacrylate was used to fill the bone defect and strengthen the internal fixation. Radiotherapy was given post-operatively to complying patients.
Results:
One patient died post-operatively. Eight cases were lost to post-operative follow-up. Four cases are still living. The remaining 26 cases survived for a median of 149 days (range 32-1220 days). Results in relief of pain and for restoration of limb function were good.
Conclusions:
Since long bone metastases with pathological fracture predictably causes disability for patients, the authors recommend aggressive surgery to improve their quality of life.