Outcome of Surgical Treatment for Metastatic Bone Disease of the Forearm

TL;DR

This paper examines the surgical outcomes for rare forearm fractures caused by metastatic bone disease, finding that surgery generally provides good function and pain relief.

Contribution

The study provides a detailed retrospective analysis of surgical treatment outcomes for rare forearm pathological fractures due to metastatic disease.

Findings

Plate and screw reconstruction was the most common surgical method used for forearm metastatic fractures.

Segmental resection resulted in excellent functional outcomes without the need for secondary surgeries.

Local complications occurred in six cases, with tumor relapse being the most frequent.

Abstract

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.

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

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.

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.

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