Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

• Published in: Cardiovascular and interventional radiology Vol. 39; no. 1; pp. 81 - 89
• Main Authors: Tian, Qing-Hua, He, Cheng-Jian, Wu, Chun-Gen, Li, Yong-Dong, Gu, Yi-Feng, Wang, Tao, Xiao, Quan-Ping, Li, Ming-Hua
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.01.2016; Springer Nature B.V
• Subjects: BIOMEDICAL RADIOGRAPHY; BONE FRACTURES; Cardiology; Cementoplasty - methods; Clinical Investigation; CURRENTS; Female; Femoral Fractures - prevention & control; Femoral Neoplasms - complications; FEMUR; Fracture Fixation, Internal - methods; Fractures, Spontaneous - prevention & control; HAZARDS; Humans; Imaging; INSTALLATION; Male; Medicine; Medicine & Public Health; Middle Aged; NEOPLASMS; NITROGEN 21; Nuclear Medicine; PAIN; Prospective Studies; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; STABILITY; Treatment Outcome; Ultrasound; UNINTERRUPTIBLE POWER SUPPLIES; Interventional internal fixation; Percutaneous cementoplasty; Pathological fracture; Proximal femur
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-015-1133-0

Purpose To compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur. Methods A total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF ( n  = 19, group A) or PCP alone ( n  = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion. Results The overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P  = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year ( P  < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B ( P  < 0.05). Conclusion PCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor.