Skip to main content
. 2019 Nov;13(3):21–27. doi: 10.5704/MOJ.1911.004

Table I.

Summary of parameters in the 6 patients with metastatic pathological fracture of proximal femur.

Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Patient 6
Age (years old) 56 73 64 56 59 63
White cell count (X109/L) 8.6 12.58 7.39 20.83 9.66 8.05
Hematocrit (%) 35.8 40.5 35.1 41.5 40.7 30
Charlson Comorbidity Index score 7 points 10 points 11 points 7 points 8 points 8 points
Modified Bauer Score 1 point 0 point 2 points 0 point 1 point 0 point
Scandinavian Sarcoma Group (SSG) survival scoring 1 point (Group B) 0 point (Group C) 1 point (Group B) 0 point (Group C) 1 point (Group B) 1 point (Group B)
Metastatic sites from pre-operative staging Lung, lymph nodes, adrenal & bone metastases Lung, liver, adrenal and bone metastases Lung, liver and bone metastases Nodal, lung, adrenal and bone metastases. Lungs and bone metastases Lung, liver, adrenal, renal and bone metastases
Site of pathological fracture Subtrochanteric Neck of femur (and tibial lytic lesion) Subtrochanteric Neck of femur Subtrochanteric Subtrochanteric fracture and lesions involving whole femur
Operation time 150 minutes 265 minutes (2 procedures) 152 minutes 420 minutes 220 minutes 305 minutes (2 procedures)
Estimated blood loss 1500mls 400 mls 400 mls 800 mls 1500 mls 4000mls
Implant used to reconstruct the modified unipolar hemiarthroplasty (MUH)

  1. Austin Moore prosthesis size 46mm

  2. Küntscher nail size 9mm X 320mm

  3. Cerclage wire 1.2mm X 3

  4. Smartset MV Endurance® bone cement 2 packets

  1. Austin Moore prosthesis size 42mm

  2. Küntscher nail size 12mm X 360mm

  3. Cerclage wire 1.2mm X 3

  4. Simplex® P bone cement 3 packets

  5. (Combined with resection of tibia metastatic lesion and reconstruction procedure)

  1. Austin Moore prosthesis size 47mm

  2. Küntscher nail size 12mm x 360mm

  3. Cerclage wire 1.2mm x 3

  4. Simplex® P bone cement 3 packets

  1. Austin Moore prosthesis size 47mm

  2. Küntscher nail size 12mm x 360mm

  3. Cerclage wire 1.2mm x 3

  4. Simplex® P bone cement 3 packets

  1. Austin Moore prosthesis size 41mm

  2. Küntscher nail size 11mm x 320mm

  3. Cerclage wire 1.2mm X 5

  4. Rush rod X1

  5. Simplex® P bone cement 4 packets

  1. Austin Moore prosthesis size 50mm

  2. Küntscher nail size 14mm X 360mm

  3. Küntscher nail size 8mm x 60mm

  4. Cerclage wire 1.2mm X3

  5. Simplex® P bone cement 5 packets

  6. 9-hole distal femur buttress plate
Post-operation hospital stay 11 days 16 days, transferred to nearby hospital 5 days Succumbed to disease at day 36 post-operation 9 days 9 days
Histopathological examination (HPE) results Metastatic anaplastic carcinoma of the thyroid Metastatic adenocarcinoma, most likely from lungs Metastatic carcinoma, most probably from renal cell carcinoma Metastatic adenocarcinoma, most likely from lungs Metastatic adenocarcinoma from the rectum Metastatic adenocarcinoma, most likely primary from the lung
Complications from surgery None Prolonged ICU admission for 15 days Surgical site infection None None

  1. Anaemia induced acute coronary syndrome

  2. Surgical site infection
Survival duration post-operation 2 months 2 months 3 months 36 days 11 months 4 months