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Sebghati J, Khalili P, Tsagkozis P. Surgical treatment of metastatic bone disease of the distal extremities. World J Orthop. 2021;12(10):743-750doi: 10.5312/wjo.v12.i10.743.
Sebghati, J., Khalili, P., & Tsagkozis, P. (2021). Surgical treatment of metastatic bone disease of the distal extremities. World journal of orthopedics, 12(10), 743-750. https://doi.org/10.5312/wjo.v12.i10.743
Sebghati, Jennifer, et al. "Surgical treatment of metastatic bone disease of the distal extremities." World journal of orthopedics vol. 12,10 (2021): 743-750. doi: https://doi.org/10.5312/wjo.v12.i10.743
Sebghati J, Khalili P, Tsagkozis P. Surgical treatment of metastatic bone disease of the distal extremities. World J Orthop. 2021 Oct 18;12(10):743-750. doi: 10.5312/wjo.v12.i10.743. eCollection 2021 Oct 18. PMID: 34754830; PMCID: PMC8554352.
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World J Orthop. 2021 Oct 18;12(10):743-750. doi: 10.5312/wjo.v12.i10.743. eCollection 2021 Oct 18.

Surgical treatment of metastatic bone disease of the distal extremities.

World journal of orthopedics

Jennifer Sebghati, Pendar Khalili, Panagiotis Tsagkozis

Affiliations

  1. Medical School, Karolinska Institute, Solna 17177, Sweden. [email protected].
  2. Department of Orthopedics, Central Hospital in Karlstad, Karlstad 65230, Sweden.
  3. Department of Orthopedic Surgery, Karolinska University hospital, Solna 17176, Sweden.

PMID: 34754830 PMCID: PMC8554352 DOI: 10.5312/wjo.v12.i10.743

Abstract

Metastatic bone disease of the distal extremities, also known as acrometastasis, is very rare. Thus, there is very limited information regarding the clinical manifestations and methods of surgical treatment. The current available literature shows that acrometastases are often encountered in the context of advanced disease and are thus associated with poor patient survival. As metastatic bone disease is generally uncurable, the goal of surgical treatment is to provide the patient with good function with as few complications as possible. In this article, we discuss the clinical manifestation of acrometastases, the methods of surgical intervention, and the expected clinical outcome. Non-surgically managed pathological fractures generally remain ununited; therefore, conservative treatment is reserved for patients with poor general condition or dismal prognosis. The current evidence suggests that in lesions of the lower arm and leg, osteosynthesis (plate and screw fixation or intramedullary nail) is the most common method of reconstruction, whereas local excision or amputation are more commonly used in cases of more distal lesions (such as ankle, foot and hand). Following surgery most patients receive adjuvant radiotherapy, even though its role is poorly documented. Close collaboration between orthopedic surgeons and medical oncologists is necessary to improve patient care and treatment outcome. Further studies are needed in order to provide stronger clinical evidence and improve decision-making, in an effort to optimize the patients' quality of life and avoid the need for revision surgery.

©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

Keywords: Distal extremities; Metastatic bone disease; Pathological fractures; Radiotherapy; Surgery

Conflict of interest statement

Conflict-of-interest statement: There are no conflicts of interest associated with any of the authors who contributed to the manuscript.

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