Abstract
Introduction
The Western Infirmary/Gartnavel General Hospital orthopaedic department is geographically located next to the Beatson Oncology Centre, a specialist regional oncology unit. Pathological femoral fractures are the commonest reason for surgical intervention in patients referred from the Beatson and we have used them as a model to establish the demographic data, referral patterns, treatment results, and survival characteristics in such a group of patients.
Methods
We have collected prospective data for the last 4 years on referrals from patients under the care of oncology services.
Results
52 patients with 53 pathological fractures and 2 impending pathological fractures of the femur during a 4 year period have been treated with a surgical intervention. The surgery included locked reconstruction femoral nailing, long stem hemiarthroplasty with distal locking and proximal femoral replacement with or without acetabular augmentation/reconstruction. 34 patients were female, 18 were male reflecting the most common primary diagnosis of breast carcinoma (30 patients). The mean age was 64 years (range 31 to 82). Post-operative complications include one death at 48 hours, 4 pulmonary emboli, a symptomatic DVT and one sciatic nerve palsy. No dislocations have occurred and there have been no implant failures at a mean of 1.2 years (range 2-26 months). We present survival characteristics based on primary tumour type and indicators of poor prognosis.
Discussion
The benefits of timely orthopaedic intervention in patients with pathological fractures is well established and this study provides further insight to aid informed decisions and provides information on surgical provision required.
