دورية أكاديمية
أعرض في EDS

Surgical Management of Metastatic Pathologic Subtrochanteric Fractures: Treatment Modalities and Associated Outcomes.

التفاصيل البيبلوغرافية
العنوان: Surgical Management of Metastatic Pathologic Subtrochanteric Fractures: Treatment Modalities and Associated Outcomes.
المؤلفون: Inchaustegui ML; Facultad de Medicina Universidad Peruana Cayetano Heredia, Lima, Peru., Ruiz K; Facultad de Medicina Universidad Peruana Cayetano Heredia, Lima, Peru., Gonzalez MR; Facultad de Medicina Universidad Peruana Cayetano Heredia, Lima, Peru., Pretell-Mazzini J; Division of Orthopedic Oncology, Miami Cancer Institute, Baptist Health System South Florida, Plantation, Florida.
المصدر: JBJS reviews [JBJS Rev] 2023 May 04; Vol. 11 (5). Date of Electronic Publication: 2023 May 04 (Print Publication: 2023).
نوع المنشور: Systematic Review; Journal Article
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 101674872 Publication Model: eCollection Cited Medium: Internet ISSN: 2329-9185 (Electronic) Linking ISSN: 23299185 NLM ISO Abbreviation: JBJS Rev Subsets: MEDLINE
أسماء مطبوعة: Publication: 2016- : Philadelphia : Wolters Kluwer
Original Publication: Needham, MA : Journal of Bone and Joint Surgery, Inc., [2013]-
مواضيع طبية MeSH: Fracture Fixation, Intramedullary*/methods , Hip Fractures*/surgery , Hip Fractures*/etiology , Bone Neoplasms*/surgery, Humans ; Male ; Female ; Aged ; Prosthesis Implantation ; Femur/surgery
مستخلص: Background: Subtrochanteric pathological fractures (PFs) occur in approximately one-third of femur bone metastases. We seek to analyze surgical treatment strategies for subtrochanteric metastatic PFs and their revision rates.
Methods: A systematic review was performed using the PubMed and Ovid databases. Reoperations as a result of complications were analyzed according to initial treatment modality, primary tumor site, and type of revision procedure.
Results: We identified a total of 544 patients, 405 with PFs and 139 with impending fractures. The study population's mean age was 65.85 years with a male/female ratio of 0.9. Patients with subtrochanteric PFs who underwent an intramedullary nail (IMN) procedure (75%) presented a noninfectious revision rate of 7.2%. Patients treated with prosthesis reconstruction (21%) presented a noninfectious revision rate of 8.9% for standard endoprostheses and 2.5% for tumoral endoprostheses (p < 0.001). Revision rates because of infection were 2.2% for standard and 7.5% for tumoral endoprostheses. There were no infections within the IMN and plate/screws group (p = 0.407). Breast was the most common primary tumor site (41%) and had the highest revision rate (14.81%). Prosthetic reconstructions were the most common type of revision procedure.
Conclusion: No consensus exists regarding the optimal surgical approach in patients with subtrochanteric PFs. IMN is a simpler, less invasive procedure, ideal for patients with a shorter survival. Tumoral prostheses may be better suited for patients with longer life expectancies. Treatment should be tailored considering revision rates, patient's life expectancy, and surgeon's expertise.
Level of Evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.
Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A941).
(Copyright © 2023 by The Journal of Bone and Joint Surgery, Incorporated.)
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تواريخ الأحداث: Date Created: 20230504 Date Completed: 20230508 Latest Revision: 20230806
رمز التحديث: 20231215
DOI: e22.00232
PMID: 37141383
قاعدة البيانات: MEDLINE
الوصف
تدمد:2329-9185
DOI:e22.00232