| Autor: |
Y M, Van der Linden, P D S, Dijkstra, H M, Kroon, J J, Lok, E M, Noordijk, J W H, Leer, C A M, Marijnen |
| Rok vydání: |
2004 |
| Předmět: |
|
| Zdroj: |
The Journal of bone and joint surgery. British volume. 86(4) |
| ISSN: |
0301-620X |
| Popis: |
A number of risk factors based upon mostly retrospective surgical data, have been formulated in order to identify impending pathological fractures of the femur from low-risk metastases. We have followed up patients taking part in a randomised trial of radiotherapy, prospectively, in order to determine if these factors were effective in predicting fractures. In 102 patients with 110 femoral lesions, 14 fractures occurred during follow-up. The risk factors studied were increasing pain, the size of the lesion, radiographic appearance, localisation, transverse/axial/circumferential involvement of the cortex and the scoring system of Mirels. Only axial cortical involvement30 mm (p = 0.01), and circumferential cortical involvement50% (p = 0.03) were predictive of fracture. Mirels' scoring system was insufficiently specific to predict a fracture (p = 0.36). Our results indicate that most conventional risk factors overestimate the actual occurrence of pathological fractures of the femur. The risk factor of axial cortical involvement provides a simple, objective tool in order to decide which treatment is appropriate. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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