Outcome of Surgical Treatment for Metastatic Bone Disease of the Forearm

Abstract

Background

Metastatic bone disease and pathological fractures in the long bones of the forearm are rare. The methods and outcomes of surgical treatment for these fractures have not been adequately described.

Aims

To analyze the outcome of surgery for pathological fractures of the forearm.

Methods and Results

Retrospective study of 30 complete and impending pathological fractures (28 consecutive patients) in the forearm, operated on in a single tertiary center between 1986 and 2020. The most common malignancy was hematological disease (multiple myeloma and lymphoma). Most fractures (n = 19) were managed with plate and screw reconstruction. In some cases, simple curettage or segmental resections of the metastasis were performed. Local complications were noted in six operations, the most common one being tumor relapse seen in three patients. Most patients had good outcomes regarding restoration of function and pain relief. There were no secondary surgeries in segmental resection, and the function was near normal.

Conclusion

Surgical reconstruction of metastases in the long bones of the forearm usually results in a good functional outcome with an acceptable complication rate. Plate osteosynthesis is often indicated. Segmental excision can be reserved for dispensable parts of the ulna and radius, with excellent results.