Metastatic Pathologic Fractures: Short Term Results of Endoprosthetic Reconstruction, Intramedullary Nail and Open Reduction Internal Fixation

What this Trial Is About

Metastatic bone tumors are the most common bone tumors in older adults and require special management due to their nature. This research evaluates and compares the short-term outcomes of three surgical treatments for metastatic pathologic fractures: prosthesis (endoprosthetic reconstruction), intramedullary nailing, and plate-screw fixation. The study aims to better understand which surgical approach best relieves pain and helps patients become mobile quickly. Important factors such as the type of primary tumor, prior chemotherapy and radiotherapy, and patient health scores will be assessed before surgery. Patients will receive one of three types of surgery based on decisions made by a multidisciplinary tumor council: endoprosthetic reconstruction (where the damaged bone and joint are replaced by a prosthesis), intramedullary nailing (where a metal nail stabilizes the bone, sometimes with bone cement), or open reduction internal fixation using plates and screws (where the fractured bone is realigned and fixed with hardware, possibly with bone cement). Each method targets specific types of fractures, such as femoral neck, trochanteric, pelvic, or shaft fractures. Participants will be evaluated using multiple functional and pain measurement tools before surgery and at several points afterward: the day after surgery, one week later, and one month later. Tools include the Musculoskeletal Tumor Society score, Toronto Extremity Salvage Score, visual analog scale for pain, and various functional scales for upper and lower extremities. Additional outcomes include hospital stay length and survival up to three months. These assessments help monitor recovery and treatment impact during the study period, which started in 2022 and is expected to continue until 2026.

Metastatic Pathologic Fractures, Short Term Results