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Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis

Zoledronate or denosumab treatment is beneficial for cancer patients with bone metastasis. However, each agent may trigger atypical femoral fractures. Incomplete atypical femoral fractures can be successfully treated with prophylactic intramedullary nailing. On the other hand, intramedullary nailing...

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Autores principales: Tamiya, Hironari, Hagizawa, Hiroki, Nakai, Takaaki, Imura, Yoshinori, Tanaka, Takaaki, Oshima, Kazuya, Ito, Toshikazu, Naka, Norifumi, Kuratsu, Shigeyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6171208/
https://www.ncbi.nlm.nih.gov/pubmed/30402317
http://dx.doi.org/10.1155/2018/7862516
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author Tamiya, Hironari
Hagizawa, Hiroki
Nakai, Takaaki
Imura, Yoshinori
Tanaka, Takaaki
Oshima, Kazuya
Ito, Toshikazu
Naka, Norifumi
Kuratsu, Shigeyuki
author_facet Tamiya, Hironari
Hagizawa, Hiroki
Nakai, Takaaki
Imura, Yoshinori
Tanaka, Takaaki
Oshima, Kazuya
Ito, Toshikazu
Naka, Norifumi
Kuratsu, Shigeyuki
author_sort Tamiya, Hironari
collection PubMed
description Zoledronate or denosumab treatment is beneficial for cancer patients with bone metastasis. However, each agent may trigger atypical femoral fractures. Incomplete atypical femoral fractures can be successfully treated with prophylactic intramedullary nailing. On the other hand, intramedullary nailing for displaced atypical femoral fractures occasionally causes problems with regard to bone healing, resulting in long-term treatment. In cancer patients with poor prognosis who experience atypical femoral fractures, improvement in activities of daily living should be the priority. Thus, we performed endoprosthetic reconstruction for a displaced atypical femoral fracture in a breast cancer patient with poor prognosis to enable walking in the early stage after the operation. Two weeks after the operation, she could successfully walk. The postoperative Musculoskeletal Tumor Society score was 47%, and it had improved to almost the preoperative level before injury (50%). In conclusion, endoprosthetic reconstruction for displaced atypical femoral fractures may be a first-line treatment approach to acquire early postoperative walking ability for improving activities of daily living in cancer patients with poor prognosis.
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spelling pubmed-61712082018-11-06 Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis Tamiya, Hironari Hagizawa, Hiroki Nakai, Takaaki Imura, Yoshinori Tanaka, Takaaki Oshima, Kazuya Ito, Toshikazu Naka, Norifumi Kuratsu, Shigeyuki Case Rep Orthop Case Report Zoledronate or denosumab treatment is beneficial for cancer patients with bone metastasis. However, each agent may trigger atypical femoral fractures. Incomplete atypical femoral fractures can be successfully treated with prophylactic intramedullary nailing. On the other hand, intramedullary nailing for displaced atypical femoral fractures occasionally causes problems with regard to bone healing, resulting in long-term treatment. In cancer patients with poor prognosis who experience atypical femoral fractures, improvement in activities of daily living should be the priority. Thus, we performed endoprosthetic reconstruction for a displaced atypical femoral fracture in a breast cancer patient with poor prognosis to enable walking in the early stage after the operation. Two weeks after the operation, she could successfully walk. The postoperative Musculoskeletal Tumor Society score was 47%, and it had improved to almost the preoperative level before injury (50%). In conclusion, endoprosthetic reconstruction for displaced atypical femoral fractures may be a first-line treatment approach to acquire early postoperative walking ability for improving activities of daily living in cancer patients with poor prognosis. Hindawi 2018-09-20 /pmc/articles/PMC6171208/ /pubmed/30402317 http://dx.doi.org/10.1155/2018/7862516 Text en Copyright © 2018 Hironari Tamiya et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Tamiya, Hironari
Hagizawa, Hiroki
Nakai, Takaaki
Imura, Yoshinori
Tanaka, Takaaki
Oshima, Kazuya
Ito, Toshikazu
Naka, Norifumi
Kuratsu, Shigeyuki
Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis
title Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis
title_full Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis
title_fullStr Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis
title_full_unstemmed Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis
title_short Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis
title_sort endoprosthetic reconstruction for a displaced atypical femoral fracture in a cancer patient with poor prognosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6171208/
https://www.ncbi.nlm.nih.gov/pubmed/30402317
http://dx.doi.org/10.1155/2018/7862516
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