engleski

Pathologic fractures due to primary and secondary bone tumors

INTRODUCTION: An individual approach to patient is essential in order to choose the most suitable surgical treatment for pathologic fractures (PF). Depending on the fracture etiology, fracture location and other patient related risk-factors, one of the various forms of surgical therapy should be chosen. AIM: To evaluate different types of surgical treatments for PF due to various bone tumors. MATERIALS AND METHODS: From 1994 to 2004, 2, 420 operations with diagnose of suspected tumor were performed. We retrospectively analyzed X-rays of all the patients with osteolytic type of bone tumor. Note: Our Department has no Emergency unit, and very rarely we treat emergency cases. RESULTS: The study was based on 157 patients with PF. The most common diagnoses in patients with PF was metastatic tumor (26% of all PF), enchondroma (19%), solitary (juvenile) bone cyst (18%), osteosarcoma (8%), and chondrosarcoma (7%). The majority of the patients with malignant primary or secondary tumors had initial nonoperative therapy during investigation and neoadjuvant therapy followed by limb salvage procedure. Enchondromas were treated by excochleation and spongioplasty, and PF were mostly purely accidental findings. Fracture healing in benign tumors was predictable without any surgical treatment. CONCLUSION: Surgical treatment depends primarily on the tumor type. Surgical and reconstruction procedures should be chosen to minimize the risk of long-term failure in patients with a good prognosis and be as simple as possible in patients with poor prognoses. The aim of surgical treatment is primary to treat/remove tumorous tissue, and than to heal fracture, maintain or restore function, and minimize pain thus improving the patient's quality of life.

orthopedic surgery; bone tumors; pathologic fractures

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