Clou fémoral proximal long pour métastases

Femoral involvement is frequently observed in bone metastases. Intramedullary nailing is a common technique for prophilactic stabilisation of femur when diaphysis or metadiaphysis are involved. Reconstructive nailing is currently used in the treatment of subtrochanteric involvements. The aim of this study is to evaluate results of contemporary femoral shaft and subtrochanteric or femoral neck metastases treated with long proximal femoral nail. A consecutive series of 27 impending or complete femoral fractures due to metastastic localisation treated with reconstructive nailing was analysed in this study. Indication to prophilactic stabilisation was defined according to Mirel’s criteria; preoperative planning included MRI, which showed the contemporary involvement of subtrochanteric region or neck also in the cases of shaft localisations. A long titanium proximal femoral nail with one distal screw inserted in a static mode was used in all patients. Improvement of the quality of life, with no mechanical problems (screw breakage or implant failure), was observed in this series. These results suggest that reconstructive nailing using a long proximal femoral nail may be considered a useful strategy for the treatment of diaphyseal and metaphyseal femoral metastatic lesions.