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Life sciences · Journal article
Trauma · October 22, 2026
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Background. Some researchers estimate that bone metastases may affect up to 70 % of cancer patients, 20 % of whom may require surgery. Bone metastases cause pain, pathological fractures, spinal cord or nerve root compression, and life-threatening hypercalcemia and may require surgery, radiation therapy, or drug treatment. The management of metastatic bone disease depends mainly on the type of primary tumor and the organ involved. If there is a risk of fracture or if pathological bone fractures have occurred, then bone stabilization or joint reconstruction with removal of the affec-ted bone and surrounding tissues is necessary. Surgical treatment of metastatic skeletal lesions is performed using either arthroplasty or osteosynthesis. This article compares the results of intramedullary, extramedullary, reinforced osteosynthesis, and transosseous extrafocal osteosynthesis of long tubular bones in metastatic tumors, with the aim of identifying clinical situations in which osteosynthesis is considered the best method of bone stabilization. The purpose of the study was to compare treatment outcomes for patients with metastatic bone tumors when using metal osteosynthesis with intramedullary rods, extramedullary plates, and reinforced metal osteosynthesis in comprehensive regimens with those when using transosseous extrafocal osteosynthesis in comprehensive regimens for restoring limb function, reducing pain, and improving patients’ quality of life in the long-term. Materials and methods. The outcomes of surgical treatment were analyzed in 32 patients (14 men and 18 women, for the period 2017–2025) with metastatic tumors of long tubular bones who were treated with various osteosynthesis methods. The study group consisted of 15 participants who underwent comprehensive treatment for metastatic tumors of long tubular bones of the extremities using surgical treatment: metal osteosynthesis with intramedullary rods, extramedullary plates, as well as reinforced metal osteosynthesis with bone cement. The comparison group included 17 patients who underwent comprehensive treatment for metastatic tumors of long tubular bones of the extremities using surgical treatment: transosseous extrafocal metal osteosynthesis with rod devices for external fixation. In both groups, the functional result of the operated limb was determined according to the Musculoskeletal Tumor Society (MSTS) staging system. Assessment of pain at the site of metastatic lesion before and after treatment was carried out according to the survey on the R.G. Watkins scale. Quality of life of patients who underwent surgical treatment was evaluated according to the EORTC QLQ-C30 system (score scale from 0 to 4). Survival was determined by the Kaplan-Meier method. Results. As a result of the treatment of 15 patients in the study group with metastatic bone tumors using metal osteosynthesis with intramedullary rods, extramedullary plates, as well as reinforced metal osteosynthesis with bone cement, postoperative complications were observed in 2 (13.3 %) cases, and relapses of the metastatic tumor in 2 (13.3 %). As a result of the treatment of 17 patients in the comparison group with metastatic bone tumors using transosseous extrafocal osteosynthesis with external fixation devices, postoperative complications were observed in 3 (17.6 %) patients, and relapses of the metastatic tumor in 3 (17.6 %). The functional result of the operated limb (according to the MSTS) in the study group was from 72.3 to 85.8 %. The functional result of the operated limb in the comparison group was from 65.4 to 72.9 % (p < 0.05). In the postoperative period, the pain syndrome in the study group (according to the R.G. Watkins scale) decreased from 93.4 to 26.6 %, and in the comparison group — from 88.2 to 52.9 % (p > 0.05). The quality of life of the patients in the study group in the postoperative period improved from 28 to 82 points and in the comparison group — from 26 to 68 points (p > 0.05). The three-year overall survival in the study group was 48.8 ± 14.6 %, in the comparison group, it was 26.6 ± 11.3 % (p < 0.05). Conclusions. 1. The use of osteosynthesis techniques in metastatic tumors of long tubular bones allowed to restore the function and weight-bearing of the limb in 93.8 % of cases. 2. Surgical treatment using osteosynthesis techniques in metastatic tumors of long tubular bones allowed to reduce pain syndrome, restore limb function and improve the quality of life of patients, as well as conduct additional specific therapy. 3. Based on the analysis of the anatomical and functio-nal results of the limb, the justification of palliative surgical treatment has been proven, namely the use of various metal osteosynthesis techniques in pathological fractures of the long bones of the limbs.