{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:41:59Z","timestamp":1788414119877,"version":"build-2803163510"},"reference-count":31,"publisher":"Bioscientifica","issue":"8","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["eor.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"\n Purpose<\/jats:title>\n \n \n The aim of this study is to compare titanium vs carbon fiber intramedullary (IM) nailing in terms of response to radiotherapy, local control of the disease, time of surgery, fluoroscopy exposure, and complications.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n \n From 2015 to 2021, 52 impending or pathologic fractures were treated with IM nailing in 47 patients: 18 males and 29 females with a mean age of 73. Titanium nails were used in 27 cases: femur (17 cases), humerus (8 cases), and tibia (2 cases). Carbon fiber nails were used in 25 cases: femur (17 cases), humerus (7 cases), and tibia (1 case).<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n \n \n At a mean follow-up of 8.4 months, most patients died from the disease (63.4%). Fracture healing without osteolysis progression was present in 52% of titanium nailing at a mean time of 6 months and in 53% of carbon fiber nails at a mean time of 4.6 months. No statistically significant difference has been shown in terms of healing (\n P<\/jats:italic>\n \u2009=\u20090.5), intraoperative fluoroscopy (\n P<\/jats:italic>\n \u2009=\u20090.7), and time of surgery in femoral nailing (\n P<\/jats:italic>\n \u2009=\u20090.6), while a significantly lower surgical time for carbon fiber humeral nailing (\n P<\/jats:italic>\n \u2009\u2009=\u20090.01) was found. Two breakages of carbon fiber femoral nails were observed, and both were treated with revision with modular tumor megaprosthesis.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n \n Our results suggest that surgical time and fluoroscopy exposure are not longer for carbon fiber nails compared to titanium ones. Healing seems to be faster in carbon fiber nails. Further clinical studies are needed to clarify the long-term outcomes of these implants.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1530\/eor-22-0001","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T05:28:15Z","timestamp":1659590895000},"page":"611-617","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":13,"title":["Intramedullary nailing for impending or pathologic fracture of the long bone: titanium vs carbon fiber peek nailing"],"prefix":"10.1530","volume":"7","author":[{"given":"Elisa","family":"Pala","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Procura","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Trovarelli","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Berizzi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9617-9882","authenticated-orcid":true,"given":"Pietro","family":"Ruggieri","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Orthopedic Clinics of North America","first-page":"515","article-title":"Incidence, location and diagnostic evaluation of metastatic bone disease","volume":"31","author":"Hage","year":"2000","unstructured":"Hage WDAboulafia AJAboulafia DM. Incidence, location and diagnostic evaluation of metastatic bone disease. Orthopedic Clinics of North America200031515\u2013528. (https:\/\/doi.org\/10.1016\/s0030-5898(0570171-1)"},{"issue":"Supplement 3","key":"bib2","series-title":"Injury","first-page":"S77","article-title":"Treatment of pathologic fractures of the proximal femur","volume":"49","author":"Angelini","year":"2018","unstructured":"Angelini ATrovarelli GBerizzi APala EBreda AMaraldi MRuggieri P. Treatment of pathologic fractures of the proximal femur. Injury201849 (Supplement 3) S77\u2013S83. (https:\/\/doi.org\/10.1016\/j.injury.2018.09.044)"},{"key":"bib3","series-title":"Injury","first-page":"In press","article-title":"New concepts in the surgical treatment of actual and impending pathological fractures in metastatic disease","author":"Cappellari","year":"2020","unstructured":"Cappellari ATrovarelli GCrim\u00ec APala EAngelini ABerizzi ARuggieri P. 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Acta Orthopaedica Belgica200470 429\u2013434."},{"key":"bib16","series-title":"European Journal of Orthopaedic Surgery and Traumatology","first-page":"509","article-title":"Anterograde femoral nail for the treatment of femoral metastases","volume":"18","author":"Maccauro","year":"2008","unstructured":"Maccauro GMuratori FLiuzza FRossi BLogroscino CA. Anterograde femoral nail for the treatment of femoral metastases. European Journal of Orthopaedic Surgery and Traumatology200818509\u2013513. (https:\/\/doi.org\/10.1007\/s00590-008-0343-4)"},{"key":"bib17","series-title":"Archives of Orthopaedic and Traumatic Surgery","first-page":"41\u2013","article-title":"Reconstruction survival of segmental megaendoprostheses: a retrospective analysis of 28 patients treated for intercalary bone defects after musculoskeletal tumor","volume":"142","author":"Streitb\u00fcrger","year":"2022","unstructured":"Streitb\u00fcrger AHardes JNottrott MGuder WK. 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The invisible nail: a technique report of treatment of a pathological humerus fracture with a radiolucent intramedullary nail. Injury201142424\u2013426. (https:\/\/doi.org\/10.1016\/j.injury.2010.10.012)"},{"key":"bib23","series-title":"Journal of Orthopaedic Trauma","first-page":"429","article-title":"Carbon fiber-reinforced PEEK versus titanium tibial intramedullary nailing: a preliminary analysis and results","volume":"34","author":"Ziran","year":"2020","unstructured":"Ziran BHO\u2019Pry EKHarris RM. Carbon fiber-reinforced PEEK versus titanium tibial intramedullary nailing: a preliminary analysis and results. Journal of Orthopaedic Trauma202034429\u2013433. (https:\/\/doi.org\/10.1097\/BOT.0000000000001756)"},{"key":"bib24","series-title":"Acta Orthopaedica Belgica","first-page":"382","article-title":"The role of surgery for haematologic neoplasms of bone","volume":"78","author":"Mavrogenis","year":"2012","unstructured":"Mavrogenis AFAngelini APala EZinzani PRuggieri P. The role of surgery for haematologic neoplasms of bone. Acta Orthopaedica Belgica201278382\u2013392."},{"key":"bib25","series-title":"Journal of the American Statistical Association","first-page":"457","article-title":"Nonparametric estimation from incomplete observations","volume":"53","author":"Kaplan","year":"1958","unstructured":"Kaplan ELMeier P. Nonparametric estimation from incomplete observations. Journal of the American Statistical Association195853457\u2013481. (https:\/\/doi.org\/10.1080\/01621459.1958.10501452)"},{"key":"bib27","series-title":"Materials","article-title":"Carbon fiber\/polyether ether ketone (CF\/PEEK) implants allow for more effective radiation in long bones","volume":"13","author":"Laux","year":"2020","unstructured":"Laux CJVillefort CEhrbar SWilke LGuckenberger MM\u00fcller DA. Carbon fiber\/polyether ether ketone (CF\/PEEK) implants allow for more effective radiation in long bones. Materials202013 1754. 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Injury201748 (Supplement 3) S55\u2013S59."},{"key":"bib31","series-title":"Neurosurgical Review","first-page":"2163","article-title":"Carbon fiber-reinforced PEEK versus titanium implants: an in vitro comparison of susceptibility artifacts in CT and MR imaging","volume":"44","author":"Kr\u00e4tzig","year":"2021","unstructured":"Kr\u00e4tzig TMende KCMohme MKniep HDreimann MStangenberg MWestphal MGauer TEicker SO. Carbon fiber-reinforced PEEK versus titanium implants: an in vitro comparison of susceptibility artifacts in CT and MR imaging. Neurosurgical Review2021442163\u20132170. (https:\/\/doi.org\/10.1007\/s10143-020-01384-2)"},{"key":"bib32","series-title":"HSS Journal","first-page":"109","article-title":"Carbon-fiber-reinforced polymer intramedullary nails perform poorly in long-bone surgery","volume":"15","author":"Fragomen","year":"2019","unstructured":"Fragomen ATTeplensky JRobert Rozbruch S. Carbon-fiber-reinforced polymer intramedullary nails perform poorly in long-bone surgery. HSS Journal201915109\u2013114. 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