Bone Diaphysis Metastases, the Ways and Results of Surgical Treatment Saving the Joints
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2019, Vol 21, Issue 2
Abstract
Background. A consequence of the progress in oncological treatment is an increasing number of bone complications associated with metastases. With appropriate choice of oncological treatment and appropriate surgical management, patients may recover their physical function and maintain the previous level of quality of life. Available surgical techniques include intramedullary nailing, stabilisation with plates and screws and the use of modular prostheses. Aim of the study: to retrospectively assess the techniques and outcomes of surgical treatment of long bone metastases at the Oncology Orthopaedics Department of the Speciality Hospital in Brzozów, present the possibilities of surgical management and benefits of the chosen method and tentatively choose the most effective approach for restoring function. Material and methods. Between 2013 and 2017, a total of 82 patients were treated for long bone metastases at the Department of Oncological Orthopaedics. The most common cancers causing bone metastases were breast cancer (37%), myeloma (16%), lung cancer (8%), kidney (15%), prostate (8%), thyroid 4%, colon 1%, uterus 1%, with other sites accounting for 10%. Pathological fractures were diagnosed in 68 patients. Before the surgical treatment, the patients’ quality of life was assessed using the Karnofsky scale, Bollen prognostic scale, severity of pain in a VAS scale, and MSTS performance scale. Metastasis morphology was evaluated with conventional radiographs, CT and PET-CT. Types of surgery comprised intramedullary nailing, the use of plates and screws and the placement of modular prostheses. Patients were divided into three groups with regard to the stabilisation systems used and another three related to tumour location (humerus, femur or tibia). Results. Post-operatively, there was a reduction of pain in the VAS scale. Function (MSTS) was best in patients treated with minimally invasive methods and modular prostheses (p <0.05). An improvement in quality of life in the Karnofsky scale was also noted. The complication rate was 7% and was related to wound healing and thromboembolic complications. Conclusions. 1. Patients with long-bone cancer metastases with pathological fractures or risk of fracture require surgical management. 2. Nailing or modular prosthesis produced the best functional result at 6 weeks post-operatively. 3. All methods of surgical treatment reduced pain and improved the quality of life.<br/><br/>
Authors and Affiliations
Piotr Szczerba, Grzegorz Guzik, Andrzej Bohatyrewicz, Daniel Kotrych
Keywords
Related Articles
- EP ID EP559841
- DOI 10.5604/01.3001.0013.1914
- Views 110
- Downloads 0
Orthopedic Procedures in Patients with Congenital Coagulation Disorders: Single Center Experience
Background. Spontaneous intraarticular bleeds in congenital coagulation disorders result in early and extensive damage to the joints and periarticular structures. Total arthroplasty is the only effective method of treati...
Porównanie wyników leczenia skolioz metodą Cotrel-Dubousset z resekcją żeber na szczycie garbu i bez resekcji w oparciu o ankietę Scoliosis Research Society.<br />
Streszczenie Wprowadzenie: Celem pracy było porównanie subiektywnych wyników leczenia chorych ze skoliozą idiopatyczną po operacji metodą Cotrel-Dubousset w połączeniu z resekcją żeber na szczycie garbu, z wynikami lecze...
Porównanie efektów klasycznego usprawniania pacjentów po aloplastyce stawu biodrowego we wczesnym okresie pooperacyjnym z dodatkowym zastosowaniem techniki rozluźniania powięziowego.
The application of nerve block in early post-operative rehabilitation after tenolysis of the flexor tendon
Background. Satisfactory outcome after flexor and extensor tenolysis depends on post-operative hand rehabilitation, but the accompanying pain presents a serious obstacle. The aim of our paper was to evaluate the effectiv...
Distant outcomes of the Chiari osteotomy 30 years follow up evaluation
Background. The aim of my paper was to assess distant treatment results of patients who were treated because of hip displasia and the Chiari osteotomy was performed on those patients. Material and methods. I evaluated tr...