Креативная хирургия и онкология (Jan 2017)
SURGICAL APPROACH TO THE TREATMENT OF PATIENTS WITH PATHOLOGICAL FRACTURES CAUSED BY METASTASIS AND PRIMARY MALIGNANT TUMORS IN LOCOMOTOR SYSTEM
Abstract
Work objective-determination of pathological fracture frequency caused by malignant tumors in locomotor system, indications and possible treatment study. The analysis of treatment of 44 patients was made. It is shown, that the frequency of this kind of pathology is 0.4%. 70.5% of patients were female, 29.5%male. The average age of patients was 53 years. The primary tumor wasn’t found in 34% of cases. The most frequent segment of metastasis spread was femoral bone84.4%. Operative therapy included exsection of the tumor followed by endoprosthesis replacement (15 cases), defect replacement with artificial materials (6), segment shortening (9), fracture stabilization only (11), biopsy (3). Pathologic fractures occurred due to breast cancer metastasis in 16 cases (36,3%). 19 (43,2%) people died in a year after the surgery. 14 (31,8%) during the second year. 15.9% (7 people) lived for thee years and 4 patients (9.1%) lived for more than 5 years after the surgery. All operated patients were socially adapted, fully self-maintaining, had no pain syndrome caused by operated extremity.Due to this experience of pathologic fractures treatment we recommend active surgical approach. The surgery doesn’t affect the disease outcome, but makes patients more socially adopted for a considerable period of time.
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