[Intramedullary stabilisation of metastatic XXXX of long bones].

@entity1 @entity174 @entity5 @entity3061 @entity3
Surgical treatment of metastatic @entity174 of long bones is mostly a palliative one. Intramedullary stabilisation without resection of @entity3 follows the aim of the palliative therapy concept. @entity1 AND METHODS: From 01.01.1995 to 30.08.2001 36 manifest and 4 impending @entity174 were registered in 22 female and 16 male @entity1 , with a mean age of 63 years. In addition, one revision was necessary due to persisting instability after humeral intramedullary bundle nailing. @entity174 were found in the humerus (n=11), femoral neck (n=6), per- and subtrochanteric region (n=12), femoral shaft (n=10) and tibia (n=2). Most of them were @entity5 of the kidneys (n=13), bronchi (n=7) and breast (n=6). One @entity1 with a solitary metastasis in the humerus received curative treatment by resection, open reduction and internal fixation. All other cases underwent palliative stabilisation. Metastatic lesions of the femoral neck were treated by resection and prosthetic replacement. The remaining @entity174 were stabilized intramedullarily without resection of @entity3 or use of bone cement. In 9 cases, a locking nail was implanted in the humerus, and one @entity1 received humeral bundle nailing. In the lower extremities, we used a classic-nail or gamma-nail in 15 and a locking nail in 8 cases. Two moribund @entity1 did not undergo surgery. RESULTS: No intraoperative complications occurred. 63 % of the @entity1 with stabilisation of the leg were able to walk at the time of discharge. The mean survival time (Kaplan-Meier) of @entity1 after palliative operation amounted to 161.5 days (95 % CI 92.7; 230.3). We found 6 postoperative complications: temporary palsy of the radial nerve (n=1), soft tissue infection (n=1), dislocation of the nail (n=2), loosening of the distal locking screw (n=1), proceeding @entity3061 with high fracture risk (n=1). CONCLUSION: Intramedullary stabilisation without resection of @entity3 using locking nails meets the requirements of palliative therapy. This procedure is less invasive and allows early weight bearing.
