Farho Mohamad Ali, Sawas Mohamad Nabhan, Alnajjar Maen, Al-Kurdi Mohammed Al-Mahdi, Nawlo Ahmad, Alloush Hani
Faculty of Medicine, University of Aleppo, Aleppo, Syria; CME Office, Faculty of Medicine, University of Aleppo, Aleppo, Syria.
Faculty of Medicine, University of Aleppo, Aleppo, Syria; CME Office, Faculty of Medicine, University of Aleppo, Aleppo, Syria.
Int J Surg Case Rep. 2023 Jul;108:108411. doi: 10.1016/j.ijscr.2023.108411. Epub 2023 Jun 21.
Breast cancer (BC) is the most common and high mortality rate cancer in females. The main complication of BC is metastases, where bone metastases (BM) are present in 90 % of women with distant metastases and commonly recurrence after BC therapy. However, treatment options are numerous, and improving patients' quality of life (QoL) is a priority.
A 58-year-old female patient presented to the emergency department with pain and movement restriction in the right lower extremity after minor trauma. Clinical history included a surgically resected BC eight years ago, besides chemotherapy and radiotherapy. After clinical and radiographic examination, we encountered a subtrochanteric femoral fracture although the patient is in the end stage, the multidisciplinary team discussed the surgery option with the patient and eventually internally fixed the fracture.
Subtrochanteric femur fractures represent a challenging orthopedic issue, ranging from 10 % to 34 % of all hip fractures. Hence, after a detailed discussion, the proximal femoral nail (PFN) was the procedure of choice acording to the patient's preferences and tumor prognosis. Proximal femoral metastasis treatment aims to improve the quality of life (QoL), alleviate bone pain, and rehabilitate skeletal function.
In this case report, we highlight the surgical decision consequences for a patient with end-stage cancer, as it may put their life at risk or improve their QoL, likewise the patient in this report.
乳腺癌(BC)是女性中最常见且死亡率高的癌症。BC的主要并发症是转移,其中90%发生远处转移的女性会出现骨转移(BM),且在BC治疗后常复发。然而,治疗选择众多,提高患者生活质量(QoL)是首要任务。
一名58岁女性患者因轻微外伤后右下肢疼痛和活动受限就诊于急诊科。临床病史包括八年前接受过手术切除的BC,此外还进行过化疗和放疗。经过临床和影像学检查,我们发现了股骨转子下骨折。尽管患者处于终末期,但多学科团队与患者讨论了手术方案,最终对骨折进行了内固定。
股骨转子下骨折是一个具有挑战性的骨科问题,占所有髋部骨折的10%至34%。因此,经过详细讨论,根据患者的偏好和肿瘤预后,股骨近端髓内钉(PFN)是首选的手术方法。股骨近端转移瘤的治疗旨在提高生活质量(QoL)、减轻骨痛和恢复骨骼功能。
在本病例报告中,我们强调了终末期癌症患者手术决策的后果,因为这可能会危及他们的生命或提高他们的QoL,本报告中的患者亦是如此。