Abstract
This is a retrospective study performed to analyse the functional outcome, complications and survival following intramedullary nailings for pathological fractures of long bones in a District General Hospital.
There were fifteen intramedullary nailings (Femur-11, Tibia- 2 , Humerus- 2) done in twelve patients during June 1999 and December 2002. There were twelve nailings in pathological fractures and three cases of prophylactic nailings. Nine patients had metastasis with known primary cancers from Ca Breast (3), Ca Bronchus (3), Ca Prostate (1), Ca Oesophagus (1) and Renal Cell Carcinoma (1). Two patients had metastasis without known primary site. There was one patient who had multiple myeloma with pathological fracture of femur.
We assessed the outcome of the treatment based on pain relief, post-fixation mobility and complications associated with the procedure.
Pain relief was achieved in about 92% cases. 67% cases with fracture of lower limbs were able to walk within a week postoperatively following nailing. One patient had deep infection leading to implant failure that needed nail removal to eradicate the infection. One patient had nonfatal pulmonary embolism. There was an incidence of thromboembolism of brachial artery that was treated by embolectomy without any sequelae.
The patients survival rate was 33% at six months and 0% at 2 years.
Reamings sent from nailing were helpful in confirming the diagnosis in 75% cases.
Despite poor life expectancy our results show good functional improvement following intramedullary nailing of pathological fractures of long bones. It is a safe way to restore limb function and improve quality of life.
The abstracts were prepared by Mr Roger Tillman. Correspondence should be addressed to BOOS at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN
