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CardioVascular and Interventional Radiology

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01-12-2012 | Clinical Investigation

Percutaneous Stabilization of Impending Pathological Fracture of the Proximal Femur

Authors: Frederic Deschamps, Geoffroy Farouil, Antoine Hakime, Christophe Teriitehau, Ali Barah, Thierry de Baere

Published in: CardioVascular and Interventional Radiology | Issue 6/2012

Abstract

Objective

Percutaneous osteosynthesis plus cementoplasty (POPC) is a minimally invasive technique that has never been reported before and that we have prospectively evaluated for patients with impending pathological fracture of the proximal femur.

Methods

We performed POPC in 12 patients (3 males, 9 females) with metastasis of the proximal femur with a high risk of fracture (Mirels’ score ≥8) between February 2010 and July 2011. Patients were not candidates for standard surgical stabilization. We analyzed the feasibility, duration, and complication of the procedure, the risk of fracture, the decrease in pain (Visual Analog Scale, VAS), and length of stay in hospital. Data were prospectively collected in all patients.

Results

The mean Mirels’ score was 9.8 ± 1.2 (range, 8–11). The technical success was 100%. POPC was performed under general anesthesia (n = 6) or conscious sedation (n = 6). The mean duration was 110 ± 43 (range, 60–180) minutes. All patients stood up and walked the second day after the procedure. The average length of stay in the hospital was 4 ± 1.6 (range, 2–7) days. We experienced two hematomas in two patients and no thromboembolic complication. For symptomatic patients (n = 8), VAS decreased from 6.5/10 (range, 2–9) before treatment to 1/10 (range, 0–3) 1 month after. No fracture occurred after a median follow-up of 145 (range, 12–608) days.

Conclusions

POPC for impending pathological fracture of the proximal femur seems to be a promising alternative for cancer patients who are not candidates for surgical stabilization. Further studies are required to confirm this preliminary experience.

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Title: Percutaneous Stabilization of Impending Pathological Fracture of the Proximal Femur
Authors: Frederic Deschamps
Geoffroy Farouil
Antoine Hakime
Christophe Teriitehau
Ali Barah
Thierry de Baere
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 6/2012
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-011-0330-8

At a glance: The STEP trials

Springer Medicine

Percutaneous Stabilization of Impending Pathological Fracture of the Proximal Femur

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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