Ghanem Mohamed, Pempe Christina, Roth Andreas
Department of Orthopedics, Traumatology and Plastic Surgery, University Hospital Leipzig, Germany.
Department of Physical Therapy and Rehabilitation, University Hospital Leipzig, Germany.
GMS Interdiscip Plast Reconstr Surg DGPW. 2025 Aug 22;14:Doc02. doi: 10.3205/iprs000191. eCollection 2025.
Arthroplasty in managing tumors of the extremities is a challenging surgery. Careful planning and the expertise of the surgical team are of utmost importance, especially when managing unpredictable intraoperative complications. In this study, we report on the surgical management of a pathological femoral neck fracture with multiple metastases with carcinoma of an unknown primary origin. Primary total hip replacement was planned. However, due to the presence of multiple metastases in the lower limb with intraoperative fracture of the distal femur, a total femoral replacement with a push-through endoprosthesis was carried out primarily. The duration for the surgical intervention was three hours and 56 minutes. Following surgery, initial intensive care was necessary due to the multimorbidity of the patient. Two days after surgery, the patient could be mobilized with full weight bearing and no restriction of range of motion of the entire left lower limb supervised by physiotherapists at ward level, which she tolerated well. The pain was significantly relieved during hospital stay. Mega-endoprostheses with push-through stems are a reliable option in cases with multiple metastases.
关节置换术用于治疗四肢肿瘤是一项具有挑战性的手术。精心规划以及手术团队的专业技能至关重要，尤其是在处理不可预测的术中并发症时。在本研究中，我们报告了一例原发性不明的癌伴多发转移所致病理性股骨颈骨折的手术治疗情况。原计划行初次全髋关节置换术。然而，由于下肢存在多发转移且术中发生股骨远端骨折，遂首先进行了带贯穿型假体的全股骨置换术。手术干预时长为3小时56分钟。术后，鉴于患者存在多种合并症，起初需要重症监护。术后两天，在病房理疗师的监督下，患者能够全负重活动，整个左下肢活动范围不受限，且耐受良好。住院期间疼痛明显缓解。带贯穿型柄的大型假体在多发转移病例中是一种可靠的选择。
