Division of Orthopaedic Trauma, Department of Orthopaedics, University of British Columbia, Vancouver, BC.
Can J Surg. 2012 Apr;55(2):95-8. doi: 10.1503/cjs.049009.
More than 140,000 new cases of cancer are diagnosed annually in Canada, nearly half of which metastasize to bone. The implications for orthopedic oncology services are potentially huge. We reviewed the experience in a major Canadian orthopedic trauma centre treating long bone metastases. The primary aim was to quantify the caseload, and the secondary aim was to report on the methods of fixation.
We conducted a retrospective review of all patients treated for pathologic lesions or fracture secondary to metastatic disease over a 20-year period from July 1987 to March 2007.
The mean number of cases treated annually was 13. Most patients came from the local oncology centre. The median length of stay in hospital was 11 days. In-hospital mortality was 14%. The fatal pulmonary embolus rate was 5% for femoral lesions. The revision rate for the operative intervention was 3%.
The caseload was much lower than anticipated, likely owing to under-referring from oncology services. The high mortality rate may reflect delay in seeking orthopedic opinion, but overall the fixation methods appeared durable.
加拿大每年诊断出超过 14 万例新癌症病例，其中近一半转移到骨骼。这对骨科肿瘤服务产生了巨大影响。我们回顾了一家加拿大主要骨科创伤中心治疗长骨转移的经验。主要目的是量化病例量，次要目的是报告固定方法。
我们对 1987 年 7 月至 2007 年 3 月 20 年间因转移性疾病导致病理性病变或骨折而接受治疗的所有患者进行了回顾性分析。
每年平均治疗病例数为 13 例。大多数患者来自当地肿瘤中心。住院中位数为 11 天。院内死亡率为 14%。股部病变肺栓塞死亡率为 5%。手术干预的翻修率为 3%。
病例量远低于预期，可能是由于肿瘤服务机构的转介不足。高死亡率可能反映了对骨科意见的延迟寻求，但总体而言，固定方法似乎耐用。
