Pathologic Fracture of Proximal Femur with Benign Bone Tumor

Abstract

Purpose : The treatment results for a proximal femur fracture caused by a benign bone lesion were evaluated. Materials and Methods : Nineteen patients (23 cases) who had been treated for proximal femur pathologic fracture from 1987 to 2002 were enrolled in this study. The mean follow-up duration was 40 months. The causes and treatments of the pathologic fractures and complications such as nonunion, deformity and recurrence were evaluated. Results : The benign bone lesions treated were fibrous dysplasia (15), simple bone cyst (3), aneurysmal bone cyst (2), giant cell tumor (2) and eosinophilic granuloma (1). An autograft (3), allograft (2), and both autograft and allograft (3) was performed after adjuvant curettage with a high-speed burr. There was no recurrence in these 8 cases. At the final course, internal fixation was performed in 18 cases (intramedullary nail (10), compressive hip screw (6), plate (1), screw (1)), a hip spica cast 3 cases and a THR 2 cases. Three cases where a hip spica cast had been performed showed a varus deformity. A refracture and deformity were prevented in 10 cases who underwent intramedullary nailing. Conclusion : The IM nail is very effective in preventing complications such as a deformity, refracture after a treatment for polyostotic fibrous dysplasia. However, in a solitary benign bone lesion, bone graft and internal fixation is effective after thorough curettage.