Management of metastatic humeral fractures: Variations according to orthopedic subspecialty, tumor characteristics.
Orthop Traumatol Surg Res
; 104(1): 59-65, 2018 02.
Article
en En
| MEDLINE
| ID: mdl-29248766
ABSTRACT
HYPOTHESIS:
This study assessed, if there was a difference in surgical decision making for metastatic humeral lesions based on; orthopaedic subspecialty, tumor characteristics. STUDY TYPE Cross sectional survey study. MATERIALS ANDMETHODS:
Twenty-four case scenarios were created by combining tumor type, life expectancy, fracture type, and anatomical location. Participants were asked for every case what treatment would you recommend? Participants were 78 (48%) orthopaedic oncologists and 83 (52%) orthopaedic surgeons that were not regularly involved in the treatment of bone tumors.RESULTS:
There was a difference between orthopaedic oncologists and other subspecialty surgeons in recommendation for specific treatments intramedullary nailing was less often recommended by orthopaedic oncologists (53%, 95%CI 47-59) compared to other surgeons (62%, 95%CI 57-67) (p=0.023); while endoprosthetic reconstruction (orthopaedic oncologists 8.8% [95%CI 6.6-11], other surgeons 3.6%[95%CI 2.3-4.8], p<0.001) and plate-screw fixation (orthopaedic oncologists 19%[95%CI 14-25], other surgeons 9.5%[95%CI 5.9-13], p=0.003) were more often recommended by orthopaedic oncologists. There was no difference in recommendation for nonoperative management. There were differences in recommendation for specific treatments based on tumor type, life expectancy, and anatomical location, but not fracture type.DISCUSSION:
Subspecialty training and patient and tumor characteristics influence the decision for operative management and the decision for a specific implant in metastatic humeral fractures. LEVEL OF EVIDENCE Level 3.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Ortopedia
/
Neoplasias Óseas
/
Pautas de la Práctica en Medicina
/
Oncología Quirúrgica
/
Fracturas Espontáneas
/
Fracturas del Húmero
Tipo de estudio:
Etiology_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Orthop Traumatol Surg Res
Año:
2018
Tipo del documento:
Article