PATHOLOGICAL FRACTURES OF THE PROXIMAL, FEMUR WITH IMPENDING SHAFT FRACTURES TREATED BY THR AND CEMENTED INTRAMEDULLARY NAILING - A REPORT OF 9 CASES

We have used total hip replacement combined with cemented intramedulla ry nailing to treat a selected group of nine patients with pathologica l fractures of the proximal femur and impending fractures of the shaft due to metastases. One patient died from cardiopulmonary failure on t he third postoperative dag, but the others were able to walk within th e first week after operation, Complications included one recurrent dis location of the THR and one fracture of an osteolytic lesion of the fe moral shaft during nail insertion, Both were managed successfully. The hybrid osteosynthesis which we describe is an alternative to the use of tumour or long-stem prostheses: it has the advantage of preserving bone stock and muscle attachments.