Year: 2025 | Month: May | Volume: 12 | Issue: 5 | Pages: 656-664
DOI: https://doi.org/10.52403/ijrr.20250569
The Comparison of Musculoskeletal Tumor Society Score (MSTS) Outcomes and Complications Between Intramedullary Nailing and Bipolar Arthroplasty in Patients with Pathological Fracture of Proximal Femur Due to Metastatic Bone Disease at the Third Month Post-Surgery
Putu Angga Dharmayuda1, Made Bramantya Karna2, I Gede Eka Wiratnaya2
1Resident, Department of Orthopaedic and Traumatology, Faculty of Medicine, University of Udayana/Prof. Ngoerah General Hospital, Denpasar, Indonesia.
2Orthopaedic and Traumatology Consultant, Department of Orthopaedic and Traumatology, Faculty of Medicine, University of Udayana/Prof. Ngoerah General Hospital, Denpasar, Indonesia.
Corresponding Author: Putu Angga Dharmayuda
ABSTRACT
INTRODUCTION: This study aims to compare the outcomes of the Musculoskeletal Tumor Society Score (MSTS) and complications between Intramedullary Nailing (IMN) and Bipolar Hemiarthroplasty (BHA) in patients with pathological fractures of the proximal femur due to Metastatic Bone Disease (MBD) at three months post-operation.
MATERIALS & METHODS: The study included 30 patients with MBD who experienced proximal femur fractures at RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar, Bali. A total of 16 patients underwent IMN, while 14 patients underwent BHA. Patient characteristics, MSTS scores, and complications such as implant failure and infection were analyzed using appropriate statistical tests. Data normality was tested with the Shapiro-Wilk test, and data homogeneity was tested with the Levene test.
RESULT: The mean age of the patients was 57.93 ± 12.97 years, with the majority being female (86.7%). The MSTS score distribution at three months post-operation showed normal and homogeneous data distribution. The mean MSTS score of patients undergoing BHA was significantly higher than those undergoing IMN (24.28 ± 2.78 vs. 17.87 ± 2.41; MD 6.41; 95%CI 4.46-8.35; p < 0.001). There were no significant differences in the proportions of implant failure (IMN 12.5% vs. BHA 7.1%; p=0.552; OR=1.86; 95%CI [0.15-22.9]) or infection (IMN 6.3% vs. BHA 14.3%; p=0.448; OR=0.4; 95%CI [0.03-4.9]) between the two groups.
CONCLUSION: Bipolar Hemiarthroplasty resulted in significantly better MSTS scores compared to Intramedullary Nailing in patients with pathological fractures due to MBD at three months post-operation. However, there were no significant differences in complications such as implant failure and infection between the two surgical techniques.
Keywords: Metastatic Bone Disease, proximal femur fractures, Intramedullary Nailing, Bipolar Hemiarthroplasty, MSTS score, complications
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