Incidence of pathological fractures due to metastases in the proximal femur in a reference hospital of an emerging economy

Abstract

Background: Cancer is the second leading cause of death in the United States (adults) and the third in Mexico: Metastases are part of its natural evolution, occurring in the majority (> 80%) at the time of death. Metastatic disease has a greater affinity for the axial skeleton, followed by the proximal segment of the femur. The increasing number of neoplasia together with the increase in treatment efficacy has increased patient life expectancy and, in turn, has increased the number of metastases and pathological fractures, with a high morbidity and mortality rate. The aim of the study is to determine the incidence of pathological fractures due to metastasis of the proximal femur treated in a referral hospital from 2009 to 2014 in an emerging economy.
Materials and methods: After receiving approval from the local research committee, an observational, cross-sectional, retrospective, and descriptive study was carried out. Medical records were evaluated and the incidence of fractures occurred in tissue previously injured by some metastatic tumour.
Results: A total of 98 fractures were treated in 95 patients, representing 0.93% of all patients, with a calculated incidence of 0.70 cases per 100,000 person-years.
Discussion: An incidence higher than that reported in previous studies was confirmed. Treatment should aim at improving the quality of life, with a stable fixation and a useful life of the fixation itself superior to the life expectancy of the patient. Primary prevention measures, such as routine examination for metastasis should be performed on this vulnerable group of patients.
Evidence level: III.