Gristina A G, Adair D M, Spurr C L
Ann Surg. 1983 Feb;197(2):128-34. doi: 10.1097/00000658-198302000-00002.
The treatment of 31 actual or pending pathologic fractures of the long bones with open reduction and internal fixation with methylmethacrylate in 25 patients with intraosseous metastatic breast cancer is reported. Twenty hips, eight femurs, and three humeri were involved. On the basis of Wilcoxon survival curves, average life expectancy was unaltered by this treatment. However, relief of pain and overall function were significantly improved by rigid internal fixation; 74% of results were rated good (23 cases); 13% fair (four cases); and 13% poor (four cases). Three patients died within three weeks of operation; the fourth poor result was a fixation failure and was repaired with good results. Thus, the efficacy and success of open reduction and internal fixation with methylmethacrylate were confirmed, even in bones with widespread involvement. The procedure is recommended for any patient with fracture or impending fracture of the long bones secondary to metastatic breast cancer, as long as that patient's predicted survival is greater than six weeks after postoperative recovery.
报告了25例患有骨内转移性乳腺癌的患者，采用切开复位并用甲基丙烯酸甲酯内固定治疗31例实际发生或即将发生的长骨病理性骨折的情况。受累部位包括20个髋部、8个股骨和3个肱骨。根据威尔科克森生存曲线，这种治疗方法并未改变平均预期寿命。然而，通过坚固的内固定，疼痛缓解和整体功能得到了显著改善；74%的结果评定为良好（23例）；13%为中等（4例）；13%为差（4例）。3例患者在术后三周内死亡；第四例差的结果是固定失败，经修复后效果良好。因此，即使在广泛受累的骨骼中，切开复位并用甲基丙烯酸甲酯内固定的疗效和成功率也得到了证实。对于任何因转移性乳腺癌继发长骨骨折或即将骨折的患者，只要其预计生存期在术后恢复后大于六周，就推荐采用该手术。
