Estimating Survival and Reconstruction Method
➤ In the absence of reliable evidence, it is the opinion of the workgroup
that surgeons utilize a validated method of estimating survival of the
patient in choosing the method of reconstruction. Longer survival
estimates may justify more durable reconstruction methods such as
arthroplasty, if clinically appropriate. (
★★★★
)
Long Stem Hemiarthroplasty
➤ In the absence of reliable evidence, it is the opinion of the workgroup
that when treating a femoral neck fracture with hemiarthroplasty, use
of a long stem can be associated with increased intra-operative and
post-operative complications and should only be used in patients with
additional lesions in the femur. (
★★★★
)
Cephalomedullary Nailing
➤ In the absence of reliable evidence, it is the opinion of the workgroup
that there is no advantage to routine use of cephalomedullary nails for
diaphyseal metastatic lesions since there does not appear to be a high
frequency of new femoral neck lesions following intramedullary nailing.
(
★★★★
)
Arthroplasty
➤ Clinicians may consider arthroplasty to improve patient function and
decrease the need for post-operative radiation therapy in patients
with pathologic fractures from metastatic carcinoma in the femur.
(
★★★★
)
