López Vicente-José, Fernández-Valencia Jenaro-Angel, Combalía Andreu, Conill Carlos, Ríos José
Servicio de Cirugía Ortopédica-Traumatología, Hospital Clínic i Provincial, Barcelona, España.
Med Clin (Barc). 2009 Jul 4;133(5):177-9. doi: 10.1016/j.medcli.2008.11.030.
To analyze the results of the surgical treatment of proximal femoral fractures secondary to metastatic bone disease, in terms of quality of life improvement and survival.
A transversal prospective study was carried out during a period of 15 months in which 20 fractures of femur from 19 patients were included, corresponding to 10 imminent fractures (IF) and 10 established fractures. Assessed final outcomes were associated complications, walking type at discharge and change in Karnofsky's scale after surgery. Mortality and survival after operation were also registered.
Surgical procedures performed were osteosynthesis (72%) and femoral arthroplasty (28%). With regard to complications, 1 patient died during the intra-operatory period and there was 1 failure of ostesyntesis that required re-operation. There was an improvement in the quality of life measured according to the Karnofsky scale after the surgery (P=.017). Survival after surgery was 2 months in the group of patients with impending fracture and 5 months in the group of patients with established fracture (P=.816).
Patients who underwent surgery for a femoral fracture secondary to a metastatic disease showed an improvement in the quality of life, according to the Karnofsky scale. Although they represent a group of patients with a short survival, the control of pain and functional improvement justifiy the procedure.
分析转移性骨病继发股骨近端骨折的手术治疗结果,评估其对生活质量改善及生存情况的影响。
开展一项为期15个月的横向前瞻性研究,纳入19例患者的20处股骨骨折,其中10例为濒发性骨折(IF),10例为已发性骨折。评估的最终结局包括相关并发症、出院时的行走类型以及术后卡氏评分的变化。同时记录手术死亡率和生存率。
所实施的手术方式包括骨固定术(72%)和股骨关节成形术(28%)。并发症方面,1例患者在手术期间死亡,1例骨固定术失败需再次手术。术后根据卡氏评分衡量,生活质量有所改善(P = 0.017)。濒发性骨折患者组术后生存2个月,已发性骨折患者组术后生存5个月(P = 0.816)。
转移性疾病继发股骨骨折接受手术治疗的患者,根据卡氏评分显示生活质量有所改善。尽管他们属于生存期较短的患者群体,但疼痛控制和功能改善证明该手术是合理的。