Curettage of lesion combined with reconstruction of intramedullary nail and bone cement for the treatment of subtrochanteric metastatic tumors of the femur.

This study investigated subtrochanteric femoral metastases using a retrospective approach by analyzing data from 109 patients with bone metastases (2015-2019). Surgical methods were compared: curettage with intramedullary nail and bone cement versus prosthetic reconstruction. Post-surgical assessments included joint function, bone metastasis-related serum markers, and complications. Univariate and multivariate logistic regression analysis was used to screen independent risk factors affecting patients' prognosis. R language was used to construct a nomogram model for predicting patients' 1- and 2-year survival, which was validated through ROC curves and the calibration chart. Patients treated with curettage showed superior postoperative outcomes, exhibiting significantly higher Karnofsky Performance Status (KPS) scores (80.00 70.00, P < 0.001) and Musculoskeletal Tumor Society Scores (MSTS) (23.86 ± 2.57 21.67 ± 3.24, P < 0.001). Both methods demonstrated comparable efficacy in pain control (VAS: 3.00 3.00, P > 0.05) and bone metabolism impact (ALP: 85.93 ± 14.44 83.19 ± 21.19; CTX-I: 3.03 ± 1.56 3.15 ± 1.75; PINP: 10.30 ± 4.41 11.57 ± 3.90; all P > 0.05). Cox regression identified treatment regimen, age, diabetes, and pre-treatment KPS score as significant survival factors (all P < 0.05). The nomogram model demonstrated high accuracy in predicting one-year and two-year survival (AUC: 0.821 and 0.790, respectively). In conclusion, curettage with intramedullary nail and bone cement enhances postoperative functional recovery and quality of life for subtrochanteric femoral metastases patients, representing a promising treatment method.