![]() Surgical modalities are widely regarded asĮffective, most of which include endoprosthetic reconstruction Reconstructions that may restore function for the expected life Purpose of treatments is to reduce pain and achieve durable Metastatic bone tumor therapy, operative interventions are stillįavorable options for patients with impending or actual fractures Patients, inducing intractable pain and inhibition to mobilityĬoncerning analgesics, radiotherapy and bisphosphonates mayĮffectively relieve pain, pathological fractures rarely heal That occur secondary to the metastases have a devastating effect on Metastatic diseases, combined with an increasing popularity inĮlderly patients suffering with metastatic bone tumors ( 2). Therapies contributes to longer life expectancy of patients with The breast, prostate, lung, kidney and colon ( 3). The potential to metastasize to bone, most of which originates from Observed malignant destructive bone lesions in adults ( 1, 2) that areĬommonly encountered by orthopedists. Metastatic neoplasms of bone are the most frequently IMN is best indicated when the patient's life expectancy is extremely limited. EPR is recommended for patients with relatively good general condition and prognosis. EPR has the advantage of better functional outcomes and higher life quality in the long term, with lower complication rates in treating metastatic lesions of the proximal femur with pathological fractures. MSTS‑93 score was higher in IMN compared with EPR at 6 weeks postoperatively (P=0.001), while the EPR group demonstrated a higher score at 6 months postoperatively (P=0.001). The complication rates were 10.5% (6/57) in the EPR group and 29.0% (9/31) in the IMN group (P=0.038). The median hospital stay in the EPR group was 8 (quartile range, 7‑9) days and 5 (quartile range, 5‑6) days in the IMN group (P=0.001). Significantly less blood loss was observed in the IMN group (345.2☖6.4 ml) than in the EPR group (631.5☑03.6 ml P=0.001). The surgery time was 142.6☒2.7 min in the EPR group and 98.7☑9.5 min in the IMN group (P=0.001). The median survival time in EPR was 10.0 months and 7.5 months in IMN. The median follow‑up period was 12.9 (range, 3‑98) months. Patients were analyzed regarding surgery time, blood loss, hospital stay, Musculoskeletal Tumor Society (MSTS) score, survival, recurrence and complications. A total of 57 patients were treated with EPR (34 males and 23 females mean age, 62.5 years) and 31 patients were stabilized with IMN (19 males and 12 females mean age, 60.2 years). The records of patients (n=88) with pathological fractures secondary to metastatic tumors of the proximal femur admitted between January 2005 and December 2014 to West China Hospital, Sichuan University (Chengdu, China) were retrospectively studied. The aim of the present study was to evaluate the clinical, functional and oncological outcomes of patients who underwent EPR compared to IMN for the treatment of proximal femur metastases to investigate the surgical indication for patients. Endoprosthetic replacement (EPR) and intramedullary nailing (IMN) are the two most commonly applied surgical methods used to treat proximal metastatic lesions however, indication of the above procedures remains controversial.
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