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CONSERVATIVE TREATMENT OF PATHOLOGICAL FRACTURE OF THE PROXIMAL FEMUR



Abstract

Case Report: Metastatic deposits in the proximal femur commonly result in pathological fracture. Conventionally these fractures are treated surgically, by internal fixation or arthroplasty. The emphasis in treating these fractures is on restoring stability to the proximal femur and relieving pain. We present two cases in which pathological fractures of the proximal femur secondary to metastatic renal carcinoma were treated conservatively with excellent functional outcomes. In both cases, the medical condition of the patient precluded surgery. A 68 year old male with a subcapital fracture of the proximal femur was treated with bedrest and mobilisation. At 6 months he was able to mobilise with crutches, swim, and had returned to almost all normal activities despite non-union of the fracture.

A 63 year old male had a pathological fracture of the proximal femur treated by DCS fixation. The fracture failed to unite and the plate fractured. Despite this the patient was able to walk with crutches, pain free. Discussion: After a pathological fracture of the proximal femur conservative management can lead to satisfactory analgesia, function and therefore quality of life.

The abstracts were prepared by Mrs Leslie O’Leary. Correspondence should be addressed to her at British Orthopaedic Association, 35–43 Lincoln’s Inn Fields, London WC2A 3PE or at l.oleary@boa.ac.uk