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Management of Long Bones Metastatic Disease: Concepts That We All Know but Not Always Remember

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dc.contributor.author Gonzalez, Marcos R.
dc.contributor.author Bryce-Alberti, Mayte
dc.contributor.author Pretell-Mazzini, Juan
dc.date.accessioned 2022-12-14T14:25:35Z
dc.date.available 2022-12-14T14:25:35Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/12900
dc.description.abstract Bones are the third most common site of metastatic disease. Treatment is rarely curative; rather, it seeks to control disease progression and palliate symptoms. Imaging evaluation of a patient with symptoms of metastatic bone disease should begin with plain X-rays. Further imaging consists of a combination of (PET)-CT scan and bone scintigraphy. We recommend performing a biopsy after imaging workup has been conducted. Metastatic bone disease is managed with a combination of systemic treatment, radiotherapy (RT), and surgery. External beam RT (EBRT) is used for pain control and postoperatively after fracture stabilization. Single-fraction and multiple-fractions schemes are equally effective achieving pain control. Adequate assessment of fracture risk should guide the decision to stabilize an impending fracture. Despite low specificity, plain X-rays are the first tool to determine risk of impending fractures. CT scan offers a higher positive predictive value and can add diagnostic value. Surgical management depends on the patient’s characteristics, tumor type, and location of fracture/bone stock. Fixation options include plate and screw fixation, intrame-dullary (IM) nailing, and endoprostheses. Despite widespread use, the need for prophylactic stabilization of the entire femur should be individually analyzed in each patient due to higher complication rates of long stems. en_US
dc.language.iso eng
dc.publisher Dove Medical Press
dc.relation.ispartofseries Orthopedic Research and Reviews
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject surgery en_US
dc.subject radiotherapy en_US
dc.subject bone metastasis en_US
dc.subject pathological fracture en_US
dc.title Management of Long Bones Metastatic Disease: Concepts That We All Know but Not Always Remember en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.2147/ORR.S379603
dc.relation.issn 1179-1462


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