[Pathological fractures and prefracture osteolytic lesions due to metastases located in the femoral diaphysis: a clinico-radiographic study, a case history review and considerations of treatment evolution].

The authors reviewed the clinical and radiographic documentation of 44 cases of metastatic lesion in the femoral diaphysis, all treated during a 15-year period at the Centro Traumatologico e Ortopedico of Florence. The results obtained with both initial nonoperative treatment (casts) as well as subsequent intramedullary fixation are evaluated with great care. The evaluation of the results in terms of survival was not possible for several reasons, not least of which the recent progress made in radiation-chemo-hormonal therapy for tumors. Despite the precarious general condition of most of the patients surgical treatment did not cause intraoperative or immediate postoperative mortality. Overall, the postoperative complications were not serious and were compensated for by good progress in systemic therapy, good nursing, and in some cases recovery of autonomy.