A Randomized Trial to Assess Patient Quality of Life and Function After Alternative Surgeries for Pathologic Fractures of the Femur

Inclusion Criteria:

- Surgeon's estimated survival ≥ 1 month

- Patients presenting for orthopaedic evaluation with a painful impending pathologic
femur fracture or displaced pathologic femur fracture in the intertrochanteric,
pertrochanteric, or subtrochanteric region of the proximal femur. The anatomic region
of interest is defined by a line drawn from the base of the femoral neck to 5 cm below
the base of the lesser trochanter or 2 diaphyseal shaft widths, whichever is greater.

- Patients with an impending fracture who have had bevacizumab are eligible provided
there will be a 3-week window between their last infusion and surgery.

- Diagnosis of widespread visceral and/or osseous metastatic disease based on clinical
and radiographic evidence. (Patients may continue on study if surgery shows a
non-malignant process.)

- All cancer diagnoses, except lymphoma, will be eligible

Exclusion Criteria:

- Estimated survival <1 month

- A large soft tissue mass or other disease involving an area outside of the defined
pertrochanteric anatomic region described above. (Patients excluded based on
intraoperative findings will be replaced on the study.)

- Prior surgical treatment of the area (i.e., revision cases). A biopsy does not
constitute prior surgical treatment.

- Radiographic evidence of an intramedullary occlusion by blastic metastases that would
necessitate an alternative method of treatment, such as a plate/screw construct.

- Diagnosis of lymphoma

- Age < 18 years

- Patients with advanced hip arthritis on radiographic imaging

- Previous randomization for a contralateral procedure as part of this study