Surgical management of metastatic disease of the proximal femur

Description: Purpose. To review the surgical treatment for metastatic disease of the proximal femur. Methods. Records of 8 patients who underwent endoprosthetic replacement with tumour resection (group 1) and 8 others who underwent intramedullary nailing without tumour resection (group 2) were reviewed. Treatments were based on the disease progression and patient’s condition. Results. In groups 1 and 2, the respective mean survival periods were 16 and 4 months. All patients in group 1 regained preoperative mobility, but only one patient in group 2 was able to walk with crutches. Conclusion. This was a retrospective, rather than comparative study of endoprothetic replacement and intramedullary nailing for metastatic disease of the proximal femur. Both procedures are considered palliative, and not curative. The longer survival period in group 1 was mainly due to selection of patients with better preoperative medical status.
H Hattori, J Mibe, H Matsuoka, S Nagai, K Yamamoto Journal of Orthopaedic Surgery 2007;15(3):295-8