The surgical treatment method for bone metastasis should be appropriate

Ms. Chen, 67 years old, had her right lung removed last year due to lung cancer. Two months ago, she suddenly developed pain in her limbs. She slammed the door hard and caused a spiral fracture of the humerus in her right hand. She rushed to the hospital for an X-ray, which revealed bone destruction. She then underwent an isotope whole-body bone scan, which diagnosed her with bone metastasis. Taking into account Ms. Chen's physical condition, the doctor decided to perform surgery on her.

Local pain is the main symptom of bone metastasis, ranging from mild to severe, and usually with severe pain in the later stage. Only a few patients can be diagnosed with bone metastasis when pathological fractures occur. The treatment of bone metastasis generally adopts comprehensive treatment with surgery as the main treatment, especially when bone metastasis causes pathological fractures, spinal instability, and spinal cord compression. According to different locations and lesion ranges, corresponding treatment methods can be selected.

1. Patients who are expected to have pathological fractures can be given preventive internal fixation.

2. For near-articular fractures, artificial prosthesis replacement is the preferred choice. For femoral neck fractures, long-stem femoral head replacement or total hip replacement can be used.

3. Femoral trochanteric fractures are fixed with Gamma nails, Ziekel nails or reconstruction nails. During the operation, the bone metastasis lesions should be removed and the bone defects can be filled with bone cement. Bone cement can assist internal fixation of the fracture and improve the mechanical strength of the tumor bone.

4. For fractures of the limb shafts, the most appropriate method is to use interlocking intramedullary nailing for internal fixation, and patients can get out of bed and move around early after surgery.