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THE MANAGEMENT OF PATHOLOGICAL FRACTURE OF THE MAJOR LONG BONES FROM METASTATIC CANCER

R. A. Bremner 1; and A. M. Jelliffe 1

1 The Department of Orthopaedics and the Myerstein Institute of Radiotherapy, the Middlesex Hospital, London

1. Problems of management of a pathological fracture of a major long bone through a metastatic cancer deposit are outlined. The relatively short life expectancy of these patients is stressed.

2. The results of treatment of thirty-six consecutive fractures of this type by internal fixation and radiotherapy, and of similar treatment used "prophylactically" on seven occasions, are reviewed.

3. Four-fifths of the patients with lower limb fractures became ambulant with crutches and were able to return home.

4. "Prophylactic" internal fixation and radiotherapy appear to be helpful in selected cases.

5. The theoretical dangers and difficulties of the technique are discussed. They are easily surmountable and have probably been over-emphasised in the past.

6. It is concluded that this is the best method at present available for dealing with this difficult problem.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General