الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Adequate treatment of patients with proximal femur metastases demands higher level of attention due to the increasing life expectancy, and the need of maintaining good functional integrity and quality of life. In the presence of impending or actual pathologic fracture, treatment requires a reconstruction which provides pain control, stable and secure fixation and allows for immediate weight-bearing. Objective: to evaluate management of proximal femoral metastasis as regards: functional outcome, oncological outcome and complications. Material and Methods: This systematic review was conducted on human subjects in different literatures collected from different medical websites before 2022 in which we compared osteosynthesis including IMN (group 1) and reconstruction whether endoprosthesis replacement, total hip arthroplasty or hip hemiarthroplasty (group 2) in treatment of proximal femoral metastasis. Fifteen (15) literatures that fulfilled the study criteria, were included in this study. Results: we would suggest that implant related complications and surgery-related morbidity should be taken into account in the decision-making process for the surgical management of these patients. These data can improve the surgeon-patient communication. Conclusion: This study provides an overview of functional, oncological outcome and complications after common surgical strategies for impending and pathological proximal metastatic femoral fractures. All the surgical strategies result in reasonable function on average; however, functional levels vary substantially. Osteosynthesis results in a high recurrence, failure rate and non-union, while Dislocation rates and infections were common in reconstruction. the survival rate was prolonged in reconstruction than in osteosynthesis by IMN. The results reported here can aid patients and their surgeons in the decision for operative treatment. |