Long proximal femoral nail for the treatment of femoral metastases: a report of 27 cases

  • G. Maccauro
  • F. Muratori
  • F. Liuzza
  • A. Sgambato
  • A. Leone
  • A. Cianfoni
  • M. A. Rosa
  • G. Gosheger
Original Article
First Online:
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Accepted:

Abstract

Femoral involvement is frequently observed in bone metastases. Intramedullary nailing is a common technique for prophilactic stabilisation of femur when diaphysis or metadiaphysis are involved. Reconstructive nailing is currently used in the treatment of subtrochanteric involvements. The aim of this study is to evaluate results of contemporary femoral shaft and subtrochanteric or femoral neck metastases treated with long proximal femoral nail. A consecutive series of 27 impending or complete femoral fractures due to metastastic localisation treated with reconstructive nailing was analysed in this study. Indication to prophilactic stabilisation was defined according to Mirel’s criteria; preoperative planning included MRI, which showed the contemporary involvement of subtrochanteric region or neck also in the cases of shaft localisations. A long titanium proximal femoral nail with one distal screw inserted in a static mode was used in all patients. Improvement of the quality of life, with no mechanical problems (screw breakage or implant failure), was observed in this series. These results suggest that reconstructive nailing using a long proximal femoral nail may be considered a useful strategy for the treatment of diaphyseal and metaphyseal femoral metastatic lesions.

Keywords

Nailing Metastasis Femur 

Clou fémoral proximal long pour métastases

Resume

La localisation fémorale des métastases est fréquente. L’enclouage centromédullaire est une méthode habituellement utilisée pour la stabilisation préventive des atteintes diaphysaires et métaphyso-diaphysaires. L’enclouage de reconstruction est utilisé dans les lésions sous-trochantériennes. Le but de cette étude est d’évaluer les rèsultats de lésions associées de la diaphyse et de la région sous-trochantérienne ou cervicale, traitées par un clou fémoral proximal long. Une série consécutive de 27 métastases fémorales fracturées ou en menace de fracture traitées par enclouage de reconstruction a été analysée. L’indication de la fixation préventive a été définie selon les critères de Mirel. Le bilan pré-opératoire a comporté une IRM qui a mis en évidence les lésions associées cervicales ou sous-trochantériennes en cas de lésions diaphysaires. Un clou fémoral proximal long en titane, statique avec une vis de verrouillage distale, a été utilisé dans tous les cas. L’amélioration de la qualité de vie et l’absence de problèmes mécaniques ont été notées dans cette série. Ces résultats suggèrent que l’enclouage par clou cervico-médullaire long représente une méthode de choix dans le traitement des métastases diaphysaires et métaphysaires proximales du fémur.

Motscles

Enclouage Métastase Fémur 
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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • G. Maccauro
    • 1
  • F. Muratori
    • 1
  • F. Liuzza
    • 1
  • A. Sgambato
    • 2
  • A. Leone
    • 3
  • A. Cianfoni
    • 3
  • M. A. Rosa
    • 4
  • G. Gosheger
    • 5
  1. 1.Department of OrthopaedicsCatholic University of RomeRomeItaly
  2. 2.Department of ExperimentalOncology Catholic University of RomeRomeItaly
  3. 3.Department of RadiologyCatholic University of RomeRomeItaly
  4. 4.Department of OrthopaedicsUniversity of MessinaMessinaItaly
  5. 5.Department of OrthopaedicsUniversity of MuensterMuensterGermany

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