Prophylactic and therapeutic fixation of weight-bearing long bones with metastatic cancer

Background. We retrospectively studied the duration of operations and the h ospitalizations for impending and manifest fractures of weight-bearing long bones with metastatic disease, which has rarely been done. Methods. The duration of operative fixation and the hospital stay in patien ts with an impending (n = 7) or actual (n = 15) fracture in a weight-bearin g long bone with metastatic tumor were assessed, including symptomatic resp onse, posttreatment mobility, and survival rate. Results. Most patients had significant relief of pain. More than half of pa tients with impending fracture and 80% with actual fracture were ambulatory after therapy; 3-year survival rates were 29% and 13%, respectively. Corre sponding mean durations for the operations were 175 minutes and 185 minutes , respectively; mean durations of hospitalization were 22 days and 16 days, respectively. Conclusion. Surgical fixation of fractures in weight-bearing long bones wit h metastatic cancer does not require excessive operative time as compared w ith that of impending fractures, does not extend hospitalization, and has a n acceptable risk-reward ratio.