OPERATIVE MANAGEMENT OF IMPENDING PATHOLOGICAL FRACTURES - A CRITICALANALYSIS OF THERAPY

Background: Evident and impending pathological fractures should be sta bilised operatively because patients are in serious pain and debilitat ed for their remaining life span. Methods: We evaluated survival and f unctional results after operative therapy. A retrospective study was c onducted concerning 116 patients with 152 impending pathological fract ures. Results: Of all operated patients, postoperatively 79% regained walking capacity and 60% required no or only occasional analgesic drug s. Patients operated on for impending pathological fractures showed be tter functional results, as well as those operated with the additional use of polymethylmethacrylate (PMMA). Prophylactic use of antibiotics reduced the number of infectious complications significantly. The med ian survival after operative therapy was 15 months. Conclusions: We co nclude that impending pathological fractures should be operatively sta bilised, if possible, with the additional use of PMMA because of bette r functional results. (C) 1997 Wiley-Liss, Inc.