Limb Salvage pp 757-762 | Cite as

Surgical Treatment of Bone Metastases

  • F. S. Santori
  • S. Ghera
  • M. Manili
  • A. Vitullo
  • A. Erriquez
Conference paper


Bone metastases is a problem of great interest as it is the most frequent kind of tumor of bone tissue. There is much discussion on the treatment to use: 15% of carcinoma develop bone metastases and this percentage increases to over 30% at the postmortem examination [1]. In 9% of cases there is a solitary bone lesion. The incidence of bone metastases varies according to the kind of neoplasm. Carcinoma of the breast develops bone metastases very frequently (49%–84% of all cases), carcinoma of the lung in 44% of cases, carcinoma of the kidney in 33%, carcinoma of the thyroid 27%–50% of cases [9]. With regard to the bladder, gastrointestinal, and uterine cancer, the bone involvement is less frequent. The preferred sites of metastases are the trunk and the proximal part of the limbs; in particular vertebral bodies, the ribs, the proximal metaphyses of long bones, humerus and femur, while the hands and feet are much less affected. The bone lesions are not life-threatening as are the metastases localized in organs such as the brain or lungs. However, bone metastases present a problem because of painful symptomatology which alters the patient’s life, compelling him to remain in bed, with a plaster cast for long periods of time. Metastases of the bones are clear signs of tumor diffusion, but death may occur several years after diagnosis. Consequently orthopaedic therapy should be applied considering this eventuality [7]. The aims of therapy will be pain control, improvement of the quality of life, and shortening of the period of hospitalization with the consequent psychological benefits and reduced costs in nursing care.


Bone Metastasis Pathological Fracture Uterine Cancer Plaster Cast Proximal Metaphyses 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Companacci M (1981) Gaggi A (ed) Tumori delle ossa e delle parti molli, vol 2, 551–569.Google Scholar
  2. 2.
    Fisher E (1982) Prognostic value of histopathology in breast and prostatic cancer. Rev Endocr Relat Cancer 11: 11–14Google Scholar
  3. 3.
    Harrington KD, Sim FH, Enis JE et al. (1976) Methylmethacrylate as an adjunct in internal fixation of pathological fractures. Experience with three hundred and seventy-five cases. J Bone Joint Surg [Am] 58: 1047–1055Google Scholar
  4. 4.
    Marcove RC, Yang D (1967) Survival times after treatment of pathological fractures. Cancer 12: 21–46Google Scholar
  5. 5.
    Santori FS, Ghera S, De Palma F, De Chiara N (1984) Treatment of pathological fractures and impending pathological fractures of the femur with Ender’s nails. Orthopedics 7(2)Google Scholar
  6. 6.
    Santori FS, Manili M, Erriquez A, Le Pera V, Ambesi-Impiombato F (1986) Bone callus formation in pathological fractures after irradiation. In: International Symposium on bone Metastases, Rome, 11–13 June 1986.Google Scholar
  7. 7.
    Sherry HS (1982) Metastatic disease of bone in orthopedic surgery. Clin Orthop 169: 28–37Google Scholar
  8. 8.
    Slack NH, Bross IDJ (1975) Influence of site of metastases on tumour growth and response to chemotherapy. Br J Cancer 32: 78–84PubMedCrossRefGoogle Scholar
  9. 9.
    Stoll BA, Parbhoo S (1983) Bone metastasis. Raven, New YorkGoogle Scholar
  10. 10.
    Swenerton KD, Legha SS, Smith T, Hortobagyi GN, Gehon EA, Yap HY, Gutterman JU, Blumenschein GR (1979) Prognostic factors in metastatic breast cancer treated with combination chemotherapy. Cancer Res 39: 1552–1562PubMedGoogle Scholar
  11. 11.
    Zickel RE, Mouradian WH (1976) Intramedullary fixation of pathological fractures and lesions of the subtrochanteric region of the femur. J Bone Joint Surg [Am]: 1061–1066Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • F. S. Santori
    • 1
  • S. Ghera
    • 2
  • M. Manili
    • 1
  • A. Vitullo
    • 1
  • A. Erriquez
    • 1
  1. 1.Orthopaedic ClinicUniversity of Rome “La Sapienza”Italy
  2. 2.“Forlanini” HospitalRomeItaly

Personalised recommendations