Objective To evaluate the better potential and functional results in
pain control in the treatment of
pathological fractures and prophylactic fixation with an intramedullary nail associated with
polymethylmethacrylate, compared with the utilization of an intramedullary nail in long bone
tumor lesions. Methods From January 2012 to September 2017, 38 patients with 42 pathological lesions (fractures or impending fractures according to the Mirels criteria) were treated surgically. Sixteen patients allocated to the control group underwent a locked intramedullary nail fixation, and 22 patients with pathological lesions were allocated to treatment with an intramedullary nail associated with
polymethylmethacrylate. Postoperatively, the patients were submitted to the Musculoskeletal
Tumor Society (MSTS) rating scale, radiographic assessment, and to the assessment of events and complications related to the treatment. Results The evaluation using the MSTS questionnaire showed better functional results in the group associated with
polymethylmethacrylate, in comparison with the control group, which obtained an average score of 16.375 out of a maximum of 30 points (54.6%). The group studied with association with
polymethylmethacrylate obtained a mean of 22.36 points (74.5%). The procedure proved to be safe, with similar complication and severity rates, and with no statistical difference in comparison with the standard treatment. Conclusion Stabilization of
tumor lesions with an internal fixation associated with the
polymethylmethacrylate demonstrated early rehabilitation and improved the quality of life, allowing rapid functional recovery. The use of
polymethylmethacrylate has advantages such as reduced
bleeding,
tumor necrosis and higher mechanical stability.