Department of Radiology, University of Alabama, Birmingham, AL 35249, USA.
Cardiovasc Intervent Radiol. 2012 Oct;35(5):1211-5. doi: 10.1007/s00270-012-0401-5. Epub 2012 May 8.
We report the case of a 43-year-old man with metastatic breast carcinoma to the proximal right femur resulting in severe painful pathological fracture. The patient experienced severe pain despite large doses of analgesia, resulting in impaired functionality and quality of life. The patient had significant comorbidities, making him a high surgical risk.
The patient was treated with cryoablation and osteoplasty, followed by a novel technique consisting of osteoplasty reinforced with bone marrow Kirschner wires (K-wires) which will be described in details in this report.
The patient reported significant pain relief after the procedure, and gained right lower extremity functionality, as compared to total immobility before the procedure.
Our technique offers an alternative feasible treatment for patients at high surgical risk with pathological fractures in weight-bearing bones, in which osteoplasty alone has a high risk of cement leakage, inadequate fracture reduction, and early refracture. To our knowledge, our technique has not been previously described.
我们报告了一例 43 岁男性患者,患有转移性乳腺癌,转移至右侧股骨近端导致严重的病理性骨折和剧烈疼痛。尽管使用了大剂量的止痛药,患者仍经历严重疼痛,导致功能和生活质量受损。患者存在严重的合并症,使他成为高手术风险患者。
患者接受了冷冻消融和骨成形术治疗,随后采用了一种新的技术,包括用骨髓克氏针(K 线)加强的骨成形术,我们将在本报告中详细描述该技术。
与术前完全不能活动相比,患者在手术后报告疼痛明显缓解,并恢复了右下肢功能。
对于高手术风险、承重骨病理性骨折的患者,我们的技术为一种可行的替代治疗方法,单独使用骨成形术存在骨水泥渗漏、骨折复位不足和早期再骨折的高风险。据我们所知,我们的技术以前没有被描述过。