Prevalence and scientific outcomes of hip fractures and subchondral insufficiency fractures of the femoral head in sufferers with tumour-induced osteomalacia.
Int Orthop. 2017 Dec;41(12):2597-2603
Authors: Kobayashi H, Ito N, Akiyama T, Okuma T, Kinoshita Y, Ikegami M, Shinoda Y, Fukumoto S, Tanaka S, Kawano H
PURPOSE: Tumour-induced osteomalacia (TIO) is a uncommon paraneoplastic syndrome normally brought on by phosphaturic mesenchymal tumours, resulting in nice misery as a consequence of bone ache and affecting high quality of life (QoL). This examine aimed to analyze the prevalence and scientific outcomes of hip fractures and subchondral insufficiency fractures (SIF) of the femoral head.
METHODS: Twelve TIO sufferers have been handled between January 2000 and December 2016 at our hospital. All underwent surgical procedure for the tumour inflicting TIO, and full removing of the tumour was achieved in 9 of 12 circumstances. Plain radiographs of the hip have been obtained in all circumstances, and magnetic resonance imaging (MRI) was obtained from 15 hips representing eight sufferers earlier than tumour removing. We evaluated the prevalence of hip fractures or SIF and their scientific outcomes.
RESULTS: Hip fractures have been noticed in six of 12 circumstances, and the overall variety of fractures was 9, of which 5 have been femoral neck, two have been intertrochanteric and two have been subtrochanteric fractures. Conservative remedy, no matter full remission of TIO, was profitable besides in a single case with impending subtrochanteric fracture. SIFs have been noticed in 11 of 24 hips. Seven of 11 hips with SIF confirmed development after surgical procedure for tumour resection.
CONCLUSIONS: Hip fractures and SIF are extremely prevalent in TIO sufferers. Surgical and medical remedy for TIO is ample for treating hip fractures conservatively. Nonetheless, SIF tends to point out development of femoral head collapse, serving as the principle reason for ache after profitable TIO remedy.
PMID: 28836028 [PubMed – indexed for MEDLINE]