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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(06): 772-776
DOI: 10.1055/s-0041-1735171
Artigo Original
Oncologia

Evaluation of Intramedullary Methods with Polymethylmethacrylate for Fixation of Bone Lesions of the Extremities[*]

Article in several languages: português | English
Marcio Moura 
1   Departamento de Cirurgia, Universidade Federal do Paraná, Curitiba, PR, Brasil
,
Diego Pereira Sanches 
2   Divisão Ortopedia Oncológica, Hospital do Trabalhador, Secretaria de Saúde do Estado do Paraná, Curitiba, PR, Brasil
,
Álvaro Ferreira Pinto 
2   Divisão Ortopedia Oncológica, Hospital do Trabalhador, Secretaria de Saúde do Estado do Paraná, Curitiba, PR, Brasil
,
Sibele Sauzem Milano 
1   Departamento de Cirurgia, Universidade Federal do Paraná, Curitiba, PR, Brasil
,
Marcella Maria Villela 
1   Departamento de Cirurgia, Universidade Federal do Paraná, Curitiba, PR, Brasil
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Abstract

Objective To evaluate the better potential and functional results in pain control in the treatment of pathological fractures and prophylactic fixation with an intramedullary nail associated with polymethylmethacrylate, compared with the utilization of an intramedullary nail in long bone tumor lesions.

Methods From January 2012 to September 2017, 38 patients with 42 pathological lesions (fractures or impending fractures according to the Mirels criteria) were treated surgically. Sixteen patients allocated to the control group underwent a locked intramedullary nail fixation, and 22 patients with pathological lesions were allocated to treatment with an intramedullary nail associated with polymethylmethacrylate. Postoperatively, the patients were submitted to the Musculoskeletal Tumor Society (MSTS) rating scale, radiographic assessment, and to the assessment of events and complications related to the treatment.

Results The evaluation using the MSTS questionnaire showed better functional results in the group associated with polymethylmethacrylate, in comparison with the control group, which obtained an average score of 16.375 out of a maximum of 30 points (54.6%). The group studied with association with polymethylmethacrylate obtained a mean of 22.36 points (74.5%). The procedure proved to be safe, with similar complication and severity rates, and with no statistical difference in comparison with the standard treatment.

Conclusion Stabilization of tumor lesions with an internal fixation associated with the polymethylmethacrylate demonstrated early rehabilitation and improved the quality of life, allowing rapid functional recovery. The use of polymethylmethacrylate has advantages such as reduced bleeding, tumor necrosis and higher mechanical stability.

Keywords

fractures, spontaneous - polymethyl methacrylate - bone neoplasms - bone cements

* The present study was carried out at the Division of Orthopedic Oncology of the Hospital de Clínicas da Universidade Federal do Paraná and the Hospital do Trabalhador – SESA, Curitiba, PR, Brazil.




Publication History

Received: 29 July 2020

Accepted: 23 April 2021

Article published online:
04 November 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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