Proximal femoral replacement for pathological fracture.

Nine patients presented to our unit with extensive metastatic destruction of the proximal femur. The extent of bone loss precluded the use of standard methods of fixation. We undertook proximal femoral replacement as a palliative treatment to restore mobility and relieve pain. Six patients mobilized satisfactorily postoperatively. Three patients did not regain independent mobility and died within 4 weeks of surgery. The major complication was dislocation, which occurred in two patients. The mean postoperative survival was 8 months. We believe proximal femoral replacement is a useful palliative procedure in selected cases of metastatic disease of the femur.