Postoperative Complications of Intramedullary Nailing for Impending and Pathologic Fractures of the Humerus Due to Bone Metastases-A Systematic Review of the Literature.

IF 2 3区 医学 Q3 ONCOLOGY
James I Griggers, Sergio Alcantar, Marcos R Gonzalez, Santiago A Lozano-Calderon
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引用次数: 0

Abstract

Intramedullary nailing (IMN) is a common option for managing impending or pathologic fractures of the humerus secondary to metastatic disease. We sought to assess the (1) early complications, (2) failure rates and mechanisms, and (3) functional outcomes. A systematic review using the PubMed, Embase, and Cochrane databases was performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The study was registered on PROSERO (CRD42023406905). The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for quality assessment. Studies describing postoperative outcomes of patients with impending or pathologic fractures of the humerus treated with IMN were included. Implant failure was classified into mechanical and nonmechanical causes. Functional outcomes were assessed via the Musculoskeletal Tumor Society (MSTS) score. Overall, 41 studies comprising 1431 patients were included. Early complications occurred in 5.5% of patients, with 2.8% of patients having systemic complications. The overall implant failure rate was 4.9%, and the mean MSTS score at the last follow-up was 79.9%. IMN was associated with good postoperative functional outcomes and low implant failure rates. Systemic complications were the most common type of early complication, and tumor progression was the main cause of implant failure. LEVEL OF EVIDENCE: III.

髓内钉治疗骨转移导致的肱骨隐匿性和病理性骨折的术后并发症--文献的系统性回顾。
髓内钉(IMN)是治疗继发于转移性疾病的肱骨即将发生或病理性骨折的常用方法。我们试图评估(1)早期并发症,(2)失败率和机制,以及(3)功能结果。我们使用 PubMed、Embase 和 Cochrane 数据库进行了一项系统性综述。研究遵循了《系统综述和元分析首选报告项目》指南。该研究已在 PROSERO 上注册(CRD42023406905)。在进行质量评估时,采用了 "加强流行病学观察性研究报告 "核对表。纳入的研究描述了接受 IMN 治疗的肱骨即将发生骨折或病理性骨折患者的术后效果。植入失败分为机械和非机械原因。功能效果通过肌肉骨骼肿瘤协会(MSTS)评分进行评估。总共纳入了 41 项研究,包括 1431 名患者。5.5%的患者出现了早期并发症,2.8%的患者出现了全身并发症。总体植入失败率为 4.9%,最后一次随访时的平均 MSTS 评分为 79.9%。IMN具有良好的术后功能效果和较低的植入失败率。全身并发症是最常见的早期并发症类型,肿瘤进展是植入失败的主要原因。证据级别:iii。
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来源期刊
CiteScore
4.70
自引率
4.00%
发文量
367
审稿时长
2 months
期刊介绍: The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.
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