Use of cryoablation and osteoplasty reinforced with Kirschner wires in the treatment of femoral metastasis

Cardiovascular and Interventional Radiology
Ahmed Kamel Abdel-AalSouheil Saddekni

Abstract

We report the case of a 43-year-old man with metastatic breast carcinoma to the proximal right femur resulting in severe painful pathological fracture. The patient experienced severe pain despite large doses of analgesia, resulting in impaired functionality and quality of life. The patient had significant comorbidities, making him a high surgical risk. The patient was treated with cryoablation and osteoplasty, followed by a novel technique consisting of osteoplasty reinforced with bone marrow Kirschner wires (K-wires) which will be described in details in this report. The patient reported significant pain relief after the procedure, and gained right lower extremity functionality, as compared to total immobility before the procedure. Our technique offers an alternative feasible treatment for patients at high surgical risk with pathological fractures in weight-bearing bones, in which osteoplasty alone has a high risk of cement leakage, inadequate fracture reduction, and early refracture. To our knowledge, our technique has not been previously described.

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Citations

Jun 5, 2014·La Radiologia medica·Dimitrios K FilippiadisAlexis Kelekis
Nov 28, 2013·Cardiovascular and Interventional Radiology·Georgia TsoumakidouAfshin Gangi
May 26, 2016·AJR. American Journal of Roentgenology·Kambiz MotamediScott Genshaft
May 8, 2018·Pain Practice : the Official Journal of World Institute of Pain·Laura Ferrer-MileoJesús González-Barboteo
Feb 27, 2019·Radiology·Pierre AulogeAfshin Gangi

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