The risk for complications and reoperations with the use of mega prostheses in bone reconstructions.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare that they have no competing interests. 4. World J Surg Oncol. 2016 Mar 10;14:80. doi: 10.1186/s12957-016-0836-2. Intramedullary nailing has sufficient durability for metastatic femoral fractures. Tanaka T(1)(2), Imanishi J(1), Charoenlap C(1), Choong PF(3)(4)(5). Author information: (1)Department of Orthopaedics, St. Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia. (2)Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan. (3)Department of Orthopaedics, St. Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia. sarcoma@bigpond.net.au. (4)Department of Surgery, St. Vincent's Hospital Melbourne, Level 2, Clinical Sciences Building, 29 Regent Street, Fitzroy, 3065, Victoria, Australia. sarcoma@bigpond.net.au. (5)Bone and Soft Tissue Sarcoma Unit, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, 3002, Victoria, Australia. sarcoma@bigpond.net.au. BACKGROUND: Surgical treatment options of femoral metastases include intramedullary nailing (IMN) and endoprosthetic reconstruction (EPR). Previous studies have demonstrated functional and oncological advantages of EPR over IMN. The purpose of this study was to (1) report the durability of IMN and (2) establish the indication of IMN for femoral metastases. METHODS: In 2003-2013, among 186 surgically treated femoral metastasis cases, we retrospectively reviewed 80 consecutive IMN cases in 75 patients, including 14 pathological and 66 impending fractures. For the decision of surgical procedure (IMN, EPR, or plating), the following factors are considered: (1) fracture pattern (impending or pathological fracture), (2) Mirels' score (≥8 or