Abstract
An experimental model has been developed in which the effects of a pathological fracture and intramedullary nailing on metastatic spread have been investigated. The endpoint used was the production of lung metastases in rats inoculated intracortically with a rhabdomyosarcoma. We have found that a pathological fracture markedly increases the incidence of lung metastases and that intramedullary nailing, by decreasing the incidence of fractures, decreases the incidence of lung metastases. The surgical procedure itself does not increase the incidence significantly. It is concluded that in metastatic disease prophylactic nailing of an impending pathological fracture is the treament of choice.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Barendsen, G. W., Janse, H. G., Deys, B. F., andHollander, C. F., 1977, Comparison of growth characteristics of experimental tumours and derived cell cultures.Cell and Tissue Kinetics,10, 469–475.
Bouma, W. H., 1981, The surgical treatment of pathological and impending pathological fractures. Dissertation, Amsterdam.
Bremner, R. A., andJelliffe, A. M., 1958, The management of pathological fracture of the major long bones from metastatic cancer.Journal of Bone and Joint Surgery,40B, 652–659.
Devas, M. B., Dickson, J. W., andJelliffe, A. M., 1956, Pathological fractures: treatment by internal fixation and irradiation.The Lancet, 484–487.
Douglass, H. O., Shukla, S. K., andMindell, E., 1976, Treatment of pathological fractures of long bones excluding those due to breast cancer.Journal of Bone and Joint Surgery,58A, 1055–1061.
Fidler, M., andStollard, G., 1977, The management of secondary neoplastic deposits in long bones by prophylactic internal fixation.Archivum chirurgicum neerlandicum, 177–185.
Francis, K. C., 1960, Prophylactic internal fixation of metastatic osseous lesions.Cancer,13, 75–76.
Haase, W., 1943, Der Küntscher-Nagel bei spontanfraktur durch hypernephrommetastase.Zentralblatt für Chirurgie,35, 1266–1268.
Harrington, K. D., Johnston, J. O., Turner, R. H., andGreen, D. L., 1972, The use of methylmethacrylate as an adjunct in the internal fixation of malignant neoplastic fractures.Journal of Bone and Joint Surgery,54A, 1665–1676.
Hoare, J. R., 1968, Malignant neoplastic fractures. Pathologic fractures.Journal of Bone and Joint Surgery,50B, 232.
Junge, H., 1951, Marknagelung in abnorm brüchigen Knochen.Hefte zur Unfallheilkunde,40, 60–70.
Katzner, M., Petit, R., andSchvingt, E., 1974, Traitement chirurgical des métastases et des fractures metastatiques des os longs.Revue de Chirurgie orthopédique,60, 387–400.
Knutson, C. O., andSpratt, J. S., 1970, The natural history and management of mammary cancer metastatic to the femur.Cancer,26, 1199–1203.
Madden, R. E., andKarpas, C. M., 1967, Arrest of circulating tumor cells versus metastases formation.Archives of Surgery,94, 307–312.
Peltier, L. F., 1951, Theoretical hazards in the treatment of pathologic fractures by the Küntscher intramedullary nail.Surgery,29, 466–471.
Peltier, L. F., andNice, C. M., 1951, Further observations upon intramedullary pressures, during the fixation of fractures by Küntscher's method.Surgery,30, 964–966.
Rieder, W., andSchumann, G., 1943, Unsere Indikation zur Marknagelung der langen röhrenknochen.Deutsche Zeitschrift für Chirurgie,257, 415–444.
Rinecker, H., andDölle, V., 1975, Zur therapie maligner extremitätenfrakturen,Münchener medizinische Wochenschrift,45, 1791–1796.
Stoffella, R., Vécsei, V., Scharf, W., andKutscha-Lissberg, E., 1980, Operations indikation und operation smethoden bei pathologischen frakturen der langen röhrenknochen.Unfallheilkunde,83, 89–96.
Tachdjian, M. O., andCompere, C. L., 1959, Pathologic fractures of the hip.SGO,109, 13–26.
Werner, W., 1970, Das Vorgehen bei skelettmetastasen.Beitrage zür Orthopaedie und Traumatologie,1, 1–4.
Zickel, R. E., andMouradian, W. H., 1976, Intramedullary fixation of pathological fractures and lesions of the subtrochanteric region of the femur.Journal of Bone and Joint Surgery,58A, 1061–1066.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bouma, W.H., Mulder, J.H. & Hop, W.C.J. The influence of intramedullary nailing upon the development of metastases in the treatment of an impending pathological fracture: an experimental study. Clin Exp Metast 1, 205–212 (1983). https://doi.org/10.1007/BF00736404
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00736404