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PubMed1981

[Surgical treatment of metastatic lesions of the long tubular bones].

The results of surgical treatment of 12 patients with metastases in long tubular bones are presented. Palliative surgery-reaction of the heads of bones or removal of the entire long tubular bone with prosthetic replacement--was performed in all cases. All the patients went through the operation well and were discharged from hospital. Pain subsided in all cases and the patients make satisfactory use of the operated extremities. The average survival time by the data of this report was 10.6 months. No local recurrences after bone resections were registered. Due to palliative surgery for metastases into long tubular bones, the patients do not suffer from pain, are mobile and self dependent again. A long survival time may be expected in some cases (solitary metastases), when such palliative procedures are employed.

Aged↗
PubMed1982

The pathology and treatment of metastatic disease of the femur.

Two hundred eighty-three pathologic fractures and 23 impending fractures of the hip and femur were analyzed and compared after surgical treatment. One hundred ninety-six fractures were treated by internal fixation or prosthetic replacement and the adjunctive use of methylmethacrylate, and 110 were treated by surgery without the use of methylmethacrylate. Pain relief, ambulatory activities and survival rates were all enhanced in the methylmethacrylate group. The six failures of fixation in the nonacrylic group might have been prevented by the use of bone cement. Breast carcinoma was the most common metastasis, comprising 56% of the series. Kidney metastases, when treated aggressively, showed many long-term survivors. Lung metastases gave the worst prognoses. The overall series survival rates were 59% at six months and 48% at 12 months. The incidence of complications including infection were not related to the use of methylmethacrylate or preoperative radiation. Although many authors have reported the advantages of methylmethacrylate in stabilization of pathological fractures, none have compared the results by analyzing pain relief, ambulatory ability and survival times in those treated with and without bone cement. This study appears to clearly indicate that methylmethacrylate enhances the stability of the pathological fracture and contributes to achieving the goals of treatment in these severely compromised patients.

Acetabulum↗