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Volume 9, Number 4, 2004

The evaluation of fitness and quality of life after palliative fixation of fractures caused by neoplastic metastases to the bones

Błażej Ciesielczyk, Dawid P. Murawa, Piotr Dzieciuchowicz


Background: Pathological fractures in the last phase of a neoplastic disease impair fitness and cause additional physical and mental
suffering. Only surgical treatment ensures stabilization of a broken bone and thus lessens the pain and restores the function of the limb.
The aim of this study is to evaluate fitness and quality of life after intramedullary fixation stabilizing of pathological fractures.
Material and methods: 12 patients (8 femoral shaft fractures, 2 pertrochanteric fractures, 2 tibial shaft fractures) were treated with this method. In all patients a disseminated neoplastic disease was diagnosed. In 10 patients closed intramedullary fixation with a Kuntscher nail was performed (in 7 patients it was locked in a dynamic manner), in two patients fixation was made with Ender nails. Fitness was evaluated according to the ability to move, to load the operated limb, the range of motion in adjacent joints and muscle atrophy. One month after the operation quality of life was evaluated according to: the ability of self care, self dependence, subjective feeling of pain, necessity of analgesic
intake and psychosomatic state.
Results: Three patients achieved preoperative fitness, despite worsened of fitness 6 patients were able to function independently and three
patients required continuous care. All patients had to take analgesics, relief in severe pain typical of fracture was observed, but chronic pain typical of metastases was still present. The patients died within 2 to 16 months after the operation.
Conclusions: Palliative intramedullary bone fixation in the last phase of a neoplastic disease makes possible stabilization of pathological fractures and is sufficient for the patient to function independently.

Signature: Rep Pract Oncol Radiother, 2004; 9(4) : 109-112


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