Pathologic fractures of the proximal femur secondary to benign bone tumors

Pathologic fractures of the proximal femur secondary to benign bone tumors often are difficult to treat because of specific anatomic features of this region and the aggressiveness of the tumors. Between 1986 and 1996, 11 pati ents presented with a pathologic fracture of the proximal femur secondary t o a benign bone tumor. All were treated with a uniform approach consisting of biopsy, intralesional curettage, high-speed burring, and reconstruction using morselized allograft, autograft, and a fixed-angle implant. The avera ge followup was 4 years 3 months (range, 24-114 months). One patient was lo st to followup. All fractures healed, and there were no local recurrences a nd no cases of avascular necrosis. Functional evaluation revealed generally good results. Patients scored a mean of 32.6 on the original Musculoskelet al Tumor Society scale and 95.8 on the revised version. The average Toronto Extremity Salvage Score was 91.3. With the numbers available, there were n o significant differences between the study group and population norms in t he Short Form-36. These results suggest that a uniform approach based on pr eservation of the femoral head can be applied successfully to the treatment of these lesions with good local tumor control, fracture healing, and acce ptable functional outcomes.