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Treatment of Metastatic Bone Disease

  • Martin Malawer

Overview

Few skeletal metastases require surgical intervention. Radiotherapy, chemotherapy or both often provide symptomatic relief. An impending or actual pathologic fracture requires operative fixation because fractures through a tumor-bearing bone rarely heal without such intervention.

The goals of fixation are to relieve pain, improve function and ambulation, facilitate medical and nursing care, and improve psychological well-being (Figures 11.1 and 11.2). The primary functional goal of surgical intervention is to allow immediate weight-bearing. Surgery should be avoided if this cannot be achieved. A variety of techniques, including prosthetic reconstruction (especially about the hip) or a combination of internal fixation combined with polymethyl methacrylate (PMMA), provides immediate fixation and stability. After the wound has healed, radiotherapy is usually used to arrest local tumor growth, permit bony repair, and prevent re-growth of tumor around the fixation device. This chapter discusses the techniques of treatment of long bone metastases.

Keywords

Renal Cell Carcinoma Proximal Femur Skeletal Metastasis Metastatic Bone Disease Prosthetic Replacement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Harrington KD. Impending pathological fractures for metastatic malignancy: evaluation and management. Instruct Course Lect. 1986;35:357–81.Google Scholar
  2. 2.
    Thompson RC. Impending fracture associated with bone destruction. Orthopaedics. 1992;15:547–50.Google Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Martin Malawer

There are no affiliations available

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