Pathological fractures in primary bone sarcomas.
Pathological fractures in patients with primary bone sarcomas should not be considered an absolute indication for amputation. Initial fracture management should include cast immobilisation or external fixation avoiding tumour-cell dissemination. The extent of fracture displacement and the type of fracture stabilisation may affect the outcome of patients with primary bone sarcomas presenting with pathological fractures. Patients with high-grade primary bone sarcomas should be treated by neo-adjuvant chemotherapy, and limb-salvage surgery. Pathological fractures in chemo-resistant primary bone sarcomas are a relative contraindication for limb salvage surgery.
First Department of Orthopaedics, Athens University Medical School, Athens, Greece. pjp@hol.gr
Panayiotis J
PJ
Papagelopoulos
Andreas F
AF
Mavrogenis
Olga D
OD
Savvidou
Ioannis S
IS
Benetos
Evanthia C
EC
Galanis
Panayotis N
PN
Soucacos
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000671:Amputation, Surgical; D001859:Bone Neoplasms / Q000401:mortality / Q000601:surgery*; D002648:Child; D005260:Female; D005592:Fracture Fixation / Q000379:methods; D005598:Fractures, Spontaneous / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage / Q000379:methods; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery; D012516:Osteosarcoma / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome