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The role of internal fixation for long bone metastasis prior to impending fracture: an experimental model

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Patients with long bone metastasis have many therapeutic options, including surgery. However, the appropriate time for surgical intervention and the use of internal fixation prior to impending fracture remains controversial. The purpose of this study was to establish a long bone metastatic model with internal fixation, and to determine whether prophylactic internal fixation for long bone metastasis prior to impending fracture would affect bone destruction, tumor progression, and mortality.

Materials and methods

We implanted VX2 tumor cells into the tibiae of 45 rabbits divided equally into three groups: internal fixation, control, and sham groups. Rabbits were monitored by X-ray and computed tomography, and blood serum levels were examined every 2 weeks.

Results

Computed tomography data revealed significantly higher bone destruction in rabbit tibiae in the sham and control groups compared with those in the fixation group; there were volumetric bone losses of 0.2, 0.4, and 2.3 % in the fixation, sham, and control groups, respectively, at 3 weeks, which increased to 1.2, 2.5, and 6.1 % at 5 weeks. Rabbits in the fixation group showed significantly prolonged survival (64.5 ± 13.5 days) in comparison with rabbits in the sham group (50.3 ± 11.6 days) and control group (38.2 ± 4.9 days).

Conclusion

Our results suggest that prophylactic internal fixation may hinder bone destruction and tumor progression, thus extending the survival period for patients with long bone metastasis.

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Acknowledgments

We thank Prof. A. Yamamoto and Dr. S. Hamamoto for providing VX2 tumor cells and technical advice, and Dr. S. Takahashi for helping with the statistical analysis. We also thank Ms. S.K. Hata for technical assistance.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan

    Mohammad Ibrahim, Hidetomi Terai, Kentaro Yamada, Akinobu Suzuki, Hiromitsu Toyoda & Hiroaki Nakamura

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  1. Mohammad Ibrahim
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  2. Hidetomi Terai
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  3. Kentaro Yamada
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  4. Akinobu Suzuki
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  5. Hiromitsu Toyoda
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  6. Hiroaki Nakamura
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Correspondence to Hidetomi Terai.

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Ibrahim, M., Terai, H., Yamada, K. et al. The role of internal fixation for long bone metastasis prior to impending fracture: an experimental model. J Orthop Sci 18, 659–666 (2013). https://doi.org/10.1007/s00776-013-0380-7

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  • DOI: https://doi.org/10.1007/s00776-013-0380-7

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