Percutaneous image-guided screws meditated osteosynthesis of impeding and pathological/insufficiency fractures of the femoral neck in non-surgical cancer patients.

Détails

ID Serval
serval:BIB_D1B6F88903D9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Percutaneous image-guided screws meditated osteosynthesis of impeding and pathological/insufficiency fractures of the femoral neck in non-surgical cancer patients.
Périodique
European journal of radiology
Auteur⸱e⸱s
Cazzato R.L., Garnon J., Tsoumakidou G., Koch G., Palussière J., Gangi A., Buy X.
ISSN
1872-7727 (Electronic)
ISSN-L
0720-048X
Statut éditorial
Publié
Date de publication
05/2017
Peer-reviewed
Oui
Volume
90
Pages
1-5
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
To present percutaneous image-guided screw-mediated osteosynthesis (PIGSMO) for fixation of impending fractures (ImF) and non-displaced/mildly displaced pathological/insufficient fractures (PF/InF) of the femoral neck in non-surgical cancer patients.
This is a double-centre single-arm observational study. Retrospective review of electronic records identified all oncologic patients who had undergone femoral neck PIGSMO. Inclusion criteria were: non-displaced or mildly displaced PF/InF, and ImF (Mirels' score ≥8); life expectancy ≥1 month; unsuitability for surgical treatment due to sub-optimal clinical fitness, refusal of consent, or unacceptable delay to systemic therapy.
Eleven patients were treated (mean age 63.7±13.5 years) due to ImF (63.6%, mean Mirels' score 10.1), PF (27.3%) or post-radiation InF (9.1%) under CT/fluoroscopy- (36.4%) or CBCT- (63.6%) guidance. Thirty-two screws were implanted and cement injection was added in 36.4% cases. Technical success was 90.9%. No procedure related complications were noted. At 1-month clinical follow-up (pain/walking impairment), 63.6% and 27.3% patients reported significant and mild improvement, respectively. Imaging follow-up (available in 63.6% cases) showed no signs of secondary fractures, neither of screws loosening at mean 2.8 months. Five patients (45.5%) died after PIGSMO (mean time interval 3.6 months).
PIGSMO is technically feasible and safe in cancer patients with limited life expectancy; it offers good short-term results. Further prospective studies are required to corroborate mid- and to prove long-term efficacy of the technique.
Mots-clé
Bone Cements, Bone Screws, Femur Neck/physiopathology, Fluoroscopy, Fracture Fixation, Internal/methods, Fractures, Spontaneous/physiopathology, Fractures, Stress/physiopathology, Humans, Neoplasms, Prospective Studies, Retrospective Studies, Bone metastasis, Impending fractures, Osteosynthesis, Pathological/insufficiency fractures, Proximal femur
Pubmed
Web of science
Création de la notice
09/10/2018 11:23
Dernière modification de la notice
20/08/2019 15:51
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