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Re: Any thoughts?
послал John Ruth 28 Ноябрь 2004, 10:06
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I have had a similar case in patient with breast ca. She had a broken Gamma nail. She had had radiation to the proximal femur. Did your patient have radiation? I think it is very difficult to get these to heal if they have had radiation. I treated my patient with revision to a similar implant(Zimmer ITST) and used OP-1 at the fracture site. She died about 1.5 years later from her cancer and the fracture never healed. She did not have significant pain and was ambulatory with a walker. I would advise against plate fixation as you need to protect the entire length of the bone to prevent fracture at the end of your fixation (due to another met). A revision to a hip prosthesis is a big blood loss procedure compared with revision to a new trochanteric type nail.
John Ruth
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