Prophylactic and therapeutic fixation of weight-bearing long bones with metastatic cancer.

BACKGROUND

We retrospectively studied the duration of operations and the hospitalizations for impending and manifest fractures of weight-bearing long bones with metastatic disease, which has rarely been done.

METHODS

The duration of operative fixation and the hospital stay in patients with an impending (n = 7) or actual (n = 15) fracture in a weight-bearing long bone with metastatic tumor were assessed, including symptomatic response, posttreatment mobility, and survival rate.

RESULTS

Most patients had significant relief of pain. More than half of patients with impending fracture and 80% with actual fracture were ambulatory after therapy; 3-year survival rates were 29% and 13%, respectively. Corresponding mean durations for the operations were 175 minutes and 185 minutes, respectively; mean durations of hospitalization were 22 days and 16 days, respectively.

CONCLUSION

Surgical fixation of fractures in weight-bearing long bones with metastatic cancer does not require excessive operative time as compared with that of impending fractures, does not extend hospitalization, and has an acceptable risk-reward ratio.