The role of prophylactic surgery in the management of metastatic hip disease.

The surgical stabilization of pathological fractures has been advocated as early as 1953 as the best form of management for this difficult problem. The treatment of impending fractures has also been advocated, although the advantages of this form of treatment has not been clearly demonstrated in the literature. A consecutive series of 99 hips treated for a pathological fracture or an impending fracture of the hip were retrospectively reviewed. The patients treated prophylactically for an impending fracture had fewer complications, a löwer postoperative mortality rate, a lesser incidence of failure of stabilization, and a greater percentage of postoperative ambulators. Survival was not improved by prophylactic surgery. Adjunctive methyl methacrylate improved fixation and decreased the incidence of failure of stabilization of both impending and pathological fractures. Copyright 2013, SLACK Incorporated.