An osteoporotic hip fracture in a 14-year-old girl undergoing chemotherapy and operated for knee osteosarcoma.
Non-weight-bearing, pre- and postsurgical immobilization, neoadjuvant and adjuvant chemotherapy are known to act on bone turnover, causing osteoporosis over short and long time periods. Treatment of fracture insurgence is very difficult because it really depends on being able to choose the right time (i.e., when immunodeficiency is less important). We report a case of spontaneous neck femur fracture during adjuvant chemotherapy in a young girl treated with resection and prosthesis reconstruction for distal femur osteosarcoma. Possible prevention and the correct approach and surgical timing are emphasized considering immunodeficiency following chemotherapy.
Zoccali
Carmine
C
Oncological Orthopaedics Department, Muscular-Skeletal Tissue Bank, IFO, Regina Elena Institute, Rome, Italy. carminezoccali@libero.it
Prencipe
Umberto
U
Ferraresi
Virginia
V
Salducca
Nicola
N
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee; D001859:Bone Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002945:Cisplatin / Q000009:adverse effects; D004317:Doxorubicin / Q000009:adverse effects; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005593:Fracture Fixation, Internal; D006620:Hip Fractures / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects; D007103:Immobilization / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008727:Methotrexate / Q000009:adverse effects; D010024:Osteoporosis / Q000209:etiology*; D012516:Osteosarcoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D011182:Postoperative Care / Q000009:adverse effects* / Q000379:methods; D011859:Radiography
D000970:Antineoplastic Agents; D004317:Doxorubicin; D002945:Cisplatin; D007069:Ifosfamide; D008727:Methotrexate