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International Orthopaedics

, Volume 35, Issue 10, pp 1537–1543 | Cite as

Surgery for pathological proximal femoral fractures, excluding femoral head and neck fractures

Resection vs. stabilisation
  • Max Zacherl
  • Gerald Gruber
  • Mathias GlehrEmail author
  • Petra Ofner-Kopeinig
  • Roman Radl
  • Manfred Greitbauer
  • Vilmos Vecsei
  • Reinhard Windhager
Original Paper

Abstract

Pathological femoral head and neck fractures are commonly treated by arthroplasty. Treatment options for the trochanteric region or below are not clearly defined. The purpose of this retrospective, comparative, double-centre study was to analyse survival and influences on outcome according to the surgical technique used to treat pathological proximal femoral fractures, excluding fractures of the femoral head and neck. Fifty-nine patients with 64 fractures were operated up on between 1998 and 2004 in two tertiary referral centres and divided into two groups. One group (S, n = 33) consisted of patients who underwent intramedullary nailing alone, and the other group (R, n = 31) consisted of patients treated by metastatic tissue resection and reconstruction by means of different implants. Median survival was 12.6 months with no difference between groups. Surgical complications were higher in the R group (n = 7) vs. the S group (n = 3), with no statistically significant difference. Patients with surgery-related complications had a higher survival rate (p = 0.049), as did patients with mechanical implant failure (p = 0.01). Survival scoring systems did not correlate with actual survival. Resection of metastases in patients with pathological fractures of the proximal femur, excluding femoral head and neck fractures, has no influence on survival. Patients with long postoperative survival prognosis are at risk of implant-related complications.

Keywords

PMMA Femoral Head Proximal Femur Pathological Fracture Metastatic Tissue 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

The authors thank Christina Levy for proofreading the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Max Zacherl
    • 1
  • Gerald Gruber
    • 1
  • Mathias Glehr
    • 1
    Email author
  • Petra Ofner-Kopeinig
    • 2
  • Roman Radl
    • 1
  • Manfred Greitbauer
    • 3
  • Vilmos Vecsei
    • 3
  • Reinhard Windhager
    • 4
  1. 1.Department of Orthopaedic SurgeryMedical University GrazGrazAustria
  2. 2.Institute for Medical Informatics, Statistics and DocumentationMedical University GrazGrazAustria
  3. 3.Department of Trauma SurgeryMedical University ViennaViennaAustria
  4. 4.Department of OrthopaedicsMedical University ViennaViennaAustria

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