title: Fractures in pediatric Ewing sarcoma.
abstract: OBJECTIVE
  To determine the incidence, timing, and clinical significance of long-bone fractures in children with Ewing sarcoma family of tumors (ESFT).
  
  
  METHODS
  We retrospectively reviewed 93 consecutive cases of ESFT of the long bones seen at a single institution over the course of a 37-year period.
  
  
  RESULTS
  Fracture occurred in 14 (15%) of 93 patients with long-bone ESFT, most commonly in the femur. Approximately 30% of patients with tumors of the femur had fractures at some point in the course of their disease. The incidence of fracture was highest among patients with tumors of the proximal third of the femur (50%); these fractures were usually present at the time of initial diagnosis. Nine (64%) of the 14 fractures occurred after the start of radiotherapy, and three of these were associated with either local recurrence or second malignancy.
  
  
  CONCLUSIONS
  Patients with femoral ESFT are at high-risk for fracture. If fractures occur after the completion of therapy, recurrence or second malignancy should be suspected.
authors.affiliation: Department of Hematology/Oncology, University of Tennessee College of Medicine, Memphis, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Wagner
authors.forename: M D
authors.initials: MD
authors.lastname: Neel
authors.forename: A S
authors.initials: AS
authors.lastname: Pappo
authors.forename: T E
authors.initials: TE
authors.lastname: Merchant
authors.forename: C A
authors.initials: CA
authors.lastname: Poquette
authors.forename: B N
authors.initials: BN
authors.lastname: Rao
authors.forename: C
authors.initials: C
authors.lastname: Rodriguez-Galindo
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005264:Femoral Fractures / Q000453:epidemiology / Q000209:etiology; D005598:Fractures, Spontaneous / Q000453:epidemiology / Q000209:etiology*; D018219:Histiocytoma, Benign Fibrous / Q000150:complications; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000150:complications; D016609:Neoplasms, Second Primary / Q000150:complications; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D013977:Tibia; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing