Pathologic Fracture, Bone Metastases, Metastatic Cancer
Conditions
Keywords
bone metastasis, pathologic fracture, endoprosthetic reconstruction, intramedullary nailing, open reduction internal fixation, plate and screws
Brief summary
This is a single center prospective study to compare the short term results of prosthesis, nail and plate-screw surgeries for metastatic pathologic fractures.
Detailed description
The most common bone tumor in elderly is metastatic bone tumors. With the prolonged life expectancy in cancer patients, the management of the metastases became an essential topic. Pathological fractures should be examined and managed with a different perspective. They usually cannot be healed by conservative methods and require surgical intervention. The primary goals of surgical intervention are to relieve pain and mobilize the patient as soon as possible. The aim of the study is to compare the short-term functional endoprosthetic recontruction, intramedullary nailing and open reduction internal fixation. The primary tumor of the patient, applied chemotherapy and radiotherapy, Mirel risk score, Charlson comorbidity index, and PathFx 3.0 survival will be evaluated preoperatively. The type of the operation will be decided at the multidisciplinary tumor council of ankara University.
Interventions
PROCEDUREendoprosthetic reconstruction
This is a type of surgery in which the affected part of the bone and joint is removed, and replaced by a prosthesis.
PROCEDUREIntramedullary nailing
This is a type of surgery in which the affected bone is stabilized by a nail. The affected part could be removed or retained. If removed, the defect is filled with bone cement.
PROCEDUREOpen reduction internal fixation with plate and screws
This is a type of surgery in which the affected part of the bone is visualized completely, after the reduction is achieved, the fixation is provided with appropriate plates and screws. Again the affected part could be removed or retained. If removed, the defect is filled with bone cement.
Sponsors
Ankara University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* metastatic pathologic fracture * operated via endoprosthesis, intramedullary nail or plate & screws
Exclusion criteria
* primary bone tumor * conservative management * neuromuscular disease * periprosthetic fractures * less than 1 month follow up
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) | Preoperative | WOMAC is a widely used functional scale for lower extremity. It is not specific for tumor patients. |
| Musculoskeletal Tumor Society (MSTS) score | Preoperative | MSTS score is for evaluating the patients with bone tumors. It consists of six domains; scored on a 0 to 5 scale and transformed into an overall score ranging from 0 to 100% with a higher score indicating better function. |
| Toronto Extremity Salvage Score (TESS) | Preoperative | TESS is widely used for the functional assessment of patients following surgery for musculoskeletal tumours. In the TESS system, specific movements for independent living and functionality are questioned and scored.While the worst score is 0, the best score for the lower extremity is 150, and the best score for the upper extremity is 145. |
| Visual analog scale (VAS) | Preoperative | VAS is a widely used scale for pain. 0 means no pain where 10 means unbearable pain. |
| Upper Extremity Functional Scale (UEFS) | Preoperative | UEFS is a functional scale for upper extremity. It is not specific for tumor patients. |
| Disabilities of Arm, Shoulder and Hand (DASH) | Preoperative | DASH is a widely used functional scale for upper extremity. It is not specific for tumor patients. |
| Lower Extremity Functional Scale (LEFS) | Preoperative | LEFS is a functional scale for lower extremity. It is not specific for tumor patients. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Survival | up to 3 months | Time that the patient lives after the surgery |
| Days at hospital after surgery | up to 1 month | Hospitalization length required after the surgery. |
Countries
Turkey (Türkiye)
Outcome results
None listed