Wounds and Injuries

All Conditions

Neoplasms

Symptoms and General Pathology

Fractures, Bone

Neoplasm Metastasis

Fractures, Spontaneous

Neoplastic Processes

This is the group of patients with metastatic pathologic fractures treated with endoprosthesis. For example, proximal femur prosthesis for femoral neck fractures.

This is the group of patients with metastatic pathologic fractures treated with intramedullary nail, and additional bone cement if needed. For example, proximal femur nail for trochanteric fractures, or long femoral nail for femoral shaft fractures.

This is the group of patients with metastatic pathologic fractures treated with open reduction internal fixation; with plates and screws. For example, reconstruction plates for pelvic fractures or 3.5 locking compression plates for humeral or femur shaft fractures.

This is a type of surgery in which the affected part of the bone and joint is removed, and replaced by a prosthesis.

endoprosthetic reconstruction

This is a type of surgery in which the affected bone is stabilized by a nail. The affected part could be removed or retained. If removed, the defect is filled with bone cement.

Intramedullary nailing

This is a type of surgery in which the affected part of the bone is visualized completely, after the reduction is achieved, the fixation is provided with appropriate plates and screws. Again the affected part could be removed or retained. If removed, the defect is filled with bone cement.

Open reduction internal fixation with plate and screws

Merve Dursun Savran, MD

Mustafa Onur Karaca, Assc. Proff

This is a single center prospective study to compare the short term results of prosthesis, nail and plate-screw surgeries for metastatic pathologic fractures.

The most common bone tumor in elderly is metastatic bone tumors. With the prolonged life expectancy in cancer patients, the management of the metastases became an essential topic.

Pathological fractures should be examined and managed with a different perspective. They usually cannot be healed by conservative methods and require surgical intervention. The primary goals of surgical intervention are to relieve pain and mobilize the patient as soon as possible.

The aim of the study is to compare the short-term functional endoprosthetic recontruction, intramedullary nailing and open reduction internal fixation.

The primary tumor of the patient, applied chemotherapy and radiotherapy, Mirel risk score, Charlson comorbidity index, and PathFx 3.0 survival will be evaluated preoperatively.

The type of the operation will be decided at the multidisciplinary tumor council of ankara University.

Metastatic Pathologic Fractures, Short Term Results

Metastatic Pathologic Fractures: Short Term Results of Endoprosthetic Reconstruction, Intramedullary Nail and Open Reduction Internal Fixation

Final MSTS, TESS, UEFS, LEFS, DASH, WOMAC, VAS will be shared when the study is completed.

MSTS score is for evaluating the patients with bone tumors. It consists of six domains; scored on a 0 to 5 scale and transformed into an overall score ranging from 0 to 100% with a higher score indicating better function.

TESS is widely used for the functional assessment of patients following surgery for musculoskeletal tumours. In the TESS system, specific movements for independent living and functionality are questioned and scored.While the worst score is 0, the best score for the lower extremity is 150, and the best score for the upper extremity is 145.

VAS is a widely used scale for pain. 0 means no pain where 10 means unbearable pain.

UEFS is a functional scale for upper extremity. It is not specific for tumor patients.

DASH is a widely used functional scale for upper extremity. It is not specific for tumor patients.

LEFS is a functional scale for lower extremity. It is not specific for tumor patients.

WOMAC is a widely used functional scale for lower extremity. It is not specific for tumor patients.

Hospitalization length required after the surgery.

Time that the patient lives after the surgery

Spots Global Cancer Trial Database for intramedullary nailing