Feasibility of percutaneous cementoplasty combined with interventional internal fixation for impending pathologic fracture of the proximal femur.

PURPOSE: To evaluate the feasibility of percutaneous cementoplasty and interventional internal fixation for stabilization of impending pathologic fracture of the proximal femur.

MATERIALS AND

METHODS

From May 2012 to August 2013, six consecutive patients (three men and three women; median age, 58.33 y ± 21.45; age range, 18-78 y) who underwent percutaneous cementoplasty plus interventional internal fixation for the treatment of metastases to the proximal femur were retrospectively analyzed. The Karnofsky performance status (KPS) and visual analog scale (VAS) score for pain were assessed before and 1 week after the procedure; moreover, the procedure duration, length of hospital stay, risk of fracture at the procedural site, and complications were assessed.

RESULTS

The KPS increased from 66.67 ± 12.11 (range, 60-90) before the procedure to 76.67 ± 13.66 (range, 60-100) 1 week after the procedure. For symptomatic patients (n = 5), the VAS score decreased from 6.80 ± 2.39 (range, 3-9) before the procedure to 1.80 ± 0.84 (range, 1-3) at 1 week after the procedure. The mean procedure duration was 90.00 minutes ± 10.56 (range, 72-102 min). The average length of hospital stay was 7 days ± 2 (range, 4-10 d). The only complication noted consisted of thrombophlebitis in one patient, on the operative side, at 15 days after the procedure. No cases of procedural site fracture during follow-up were noted (median, 192 d; range, 30-365 d).

CONCLUSIONS

Percutaneous cementoplasty plus interventional internal fixation is a feasible technique for stabilization of impending pathologic fracture of the femur.