Unit of Musculoskeletal Surgery, Department of Orthopaedics, University Hospital of Tampere, PO Box 2000, 33521 Tampere, Finland.
Arch Orthop Trauma Surg. 2011 Apr;131(4):503-8. doi: 10.1007/s00402-010-1172-6. Epub 2010 Aug 26.
Bone metastasis is a severe complication for patients with cancer. Not only does it cause intractable pain and other clinical problems such as fracture after trivial injury, it also signifies that the malignant process is incurable. Since life expectancy of metastasised cancer patients has improved due to advanced oncological treatment but is still limited, appropriate surgical intervention has increased.
This is a retrospective control study of 21 patients who underwent cemented intramedullary nailing for pathological fractures in the humeral shaft between 2005 and 2009 as compared to a historical control group of 19 patients that underwent locked intramedullary nailing for pathological fractures in the humeral shaft between 1999 and 2004. Four major outcomes were assessed, namely, pain relief, use of analgesics, recovery of function and rate of complication.
Patients treated with cemented intramedullary nailing had better pain relief, less use of analgesics and better functional restoration immediately after surgical procedure when compared to the patients without cement fixing. The rate of complication did not differ between these two groups.
Since surgery for metastases does not prolong life but improves the quality of life, the aim towards a short postoperative rehabilitation time is recommended. Cement fixation gives immediate stabilisation to the fracture site and thus allows less pain but full range of motion from the first postoperative day.
骨转移是癌症患者的严重并发症。它不仅会导致难治性疼痛和其他临床问题，如轻微损伤后的骨折，还表明恶性过程是不可治愈的。由于转移性癌症患者的预期寿命因先进的肿瘤治疗而提高，但仍然有限，因此适当的手术干预增加了。
这是一项回顾性对照研究，比较了 2005 年至 2009 年间接受骨水泥髓内钉治疗肱骨干病理性骨折的 21 例患者与 1999 年至 2004 年间接受锁定髓内钉治疗肱骨干病理性骨折的历史对照组。评估了四个主要结局，即疼痛缓解、镇痛药使用、功能恢复和并发症发生率。
与未固定水泥的患者相比，接受骨水泥髓内钉治疗的患者在手术即刻有更好的疼痛缓解、更少的镇痛药使用和更好的功能恢复。这两组的并发症发生率没有差异。
由于转移性疾病的手术并不能延长生命，但可以提高生活质量，因此推荐术后康复时间短的目标。水泥固定可立即稳定骨折部位，从而减少疼痛，但可从术后第一天开始进行全范围运动。
