2016, Number 4
<< Back Next >>
Acta Ortop Mex 2016; 30 (4)
Pathological fracture rate due to proximal femur metastasis at a referral hospital
Trujillo-González R, Nieto-Lucio L, Mendoza-Breton JA
Language: Spanish
References: 23
Page: 176-180
PDF size: 203.08 Kb.
ABSTRACT
Objective: To report the incidence of pathological fractures secondary to metastasis at a national referral hospital during a 5-year period.
Methods: Total admissions to our center were recorded, together with the patients who met the requirement of having a proximal femur fracture in a pathological area. The potential number of beneficiaries was estimated based on official figures and the hospital’s area of influence. The annual incidence rate and the incidence density were calculated using the latter data.
Results: 98 fractures were identified in 95 patients. The calculated incidence density was 0.70/100,000 population during the observation period. Fifty-four female patients and 41 male patients were included. Mean age was 65.3 years, with a very wide age range (18-90 years). Most patients had metastasis of solid tumors. Twenty-nine percent of patients were treated conservatively and the rest of them required surgery that included from osteosynthesis to prosthetic arthroplasty. The mean length of stay was over one week.
Conclusions: The reported incidence of this type of fractures is relatively low. We found a wide variety of anatomical origins and locations. As of now, it is not possible to generalize the treatment or predict the survival.
REFERENCES
Sistema Nacional de Información en Salud: Principales causas de mortalidad. (Citado: 10 de Septiembre de 2014.) Disponible en: http://www.sinais.salud.gob.mx).
Subsecretaría de Prevención y Promoción de la Salud. Los 5 tipos de cáncer que más afectan a mexicanos. (Citado: 11 de Septiembre de 2014.) Disponible en: http://www.spps.gob.mx)
Doung YC, Kenan S, Rapp T: Metastatic lesions of the proximal femur. Bull NYU Hosp Jt Dis. 2011; 69(1): 81-6.
Greenspan A, Remagen W: Metastasis. En: Tumores de huesos y articulaciones. ISBN: 9788471013637, Ed. Marban; 2002: 367-88.
Chandrasekar CR, Grimer RJ, Carter SR, Tillman RM, Abudu AT: Modular endoprosthetic replacement for metastatic tumours of the proximal femur. Journal of Orthopaedic Surgery and Research. 2008; 3: 50.
Pereira BC. Enfermedad metastásica. En: Actualización en patología de tumores. Bogotá, Colombia: Sociedad Colombiana de Cirugía Ortopédica y Traumatología; SCCOT: 2011: 21-31.
Garbayo AJ, Villafracna E, Blas AD, Tejero A, Eslava E, Manterola A, et al: Enfermedad metastásica ósea. Diagnóstico y tratamiento. Anales Sist San Navarra. 2004; 27(S3): 137-53.
American Cancer Society, Cancer Facts & Figures 2014. Available in: www.cancer.org/acs/groups/content/@research/documents/webcontent/acspc-042151.pdf visto el August 1, 2014.
Coleman RE: Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006; 12(20S): S5243-9.
Dürr HR, Müller PE, Lenz T, Baur A, Jansson V, Refior HJ: Surgical treatment of bone metastases in patients with breast Cancer. Clin Orthop Relat Res. 2002; 396: 191-6.
Berjon RJ, Rubio QR, Nieva NF, De La Vega OA: Tratamiento quirúrgico de las fracturas patológicas metastásicas del fémur proximal. Rev Ortop Traumatol. 2002; 2: 141-8.
Fakler JK, Hase F, Böhme J, Josten C: Safety aspects in surgical treatment of pathological fractures of the proximal femur-modular endoprosthetic replacement versus intramedullary nailing. Patient Saf Surg. 2013; 7(1): 37. doi:10.1186/1754-9493-7-37.
Friedl W: Pathological fractures of the proximal femur end. Zentrañbl Chir. 1995; 120(11): 873-80.
Harvey N, Ahlmann ER, Allison DC, Wang L, Menendez LR: Endoprostheses last longer than intramedullary devices in proximal femur metastases. Clin Orthop Relat Res. 2012; 470(3): 684-91.
Saad F, Lipton A, Cook R, Chen Y, Smith M, Coleman R: Pathologic fractures correlate with reduced survival in patients with malignant bone disease. Cancer. 2007; 110(8): 1860-7.
Fukutomi M, Yokota M, Chuman H, Harada H, Zaitsu Y, Funakoshi A, et al: Increased incidence of bone metastases in hepatocellular carcinoma. Eur J Gastroenterol Hepatol. 2001; 13(9): 1083-8.
Rucci N, Angelucci A: Prostate cancer and bone: the elective affinities. Bio Med Research International. 2014; 2014: Article ID 167035, 14. doi: http://dx.doi.org/10.1155/2014/167035
Lopez MT. Fractura de cadera. Ajustada por edad, sexo y época del año en centro de trauma público Mexicano en el lapso de 2006 a 2010. [Tesis]. Posg. en Ort. México. D.F. Univ. Nac. Auto. de Mex. Fac. Med. 22.
Heck RK: Tumores óseos malignos. En: Canale ST, Beaty JH: Campbell’s Operative Orthopaedics. 11.a ed. Philadelphia: Mosby Elsevier; 2008. ISBN: 978-84-8086-392-6, 901-938.
Steensma M, Healey JH: Trends in the surgical treatment of pathologic proximal femur fractures among muscoloeskeletal tumor society members. Clin Orthop Relat Res. 2003; 471: 2000-2006. doi: 10.1007/s11999-012-2724-6.
Wedin R, Bauer HC: Surgical treatment of skeletal metastasic lesion of the proximal femur: endoposthesis or reconstruction nail? J Bone Joint Surg Br. 2005; 87(12): 1653-7.
Wedin R, Bauer HC, Wersäl P: Failures after operation for skeletal metastatic lesions of long bones. Clin Orthop Relat Res. 1999; 358: 128-39.
Sarahrudi K, Greitbauer M, Platzer P, Hausmann JT, Heinz T, Vécsei V. Surgical treatment of metastasic fractures of the femur: a retrospective analysis of 142 patients. J Trauma. 2009; 66(4): 1158-63. doi 10.1097/TA.0b013e3181622bca.