Pathologic Fracture of Primary Malignant Bone Tumor: Survival, Limb Salvage, Local recurrence

Jeon, Dae Geun; Lee, Jong Seok; Yang, Hyun Suck; Park, Jae Wan; Lee, Soo Yong

Abstract

PURPOSE
This study analyzes the indication, survival rate, local recurrence and limb salvage possibility of primary malignant bone tumors that have had pathologic fractures.
MATERIALS AND METHODS
Eighteen cases that received preoperative chemotherapy and surgery were eligible for this study. Primary tumors were osteosarcoma (13) , Ewing's sarcoma (2) and MFH (3) . Primary locations were femur (10) , humerus (6) , and tibia (2) . Fractures were classified into three grades. Grade I (10) was mild displacement, II (5) was moderate but intracompartmental, III (3) was extracompartmental. Average follow-up was 40 months. RESULT: Limbs were salvaged in 16 cases, 2 cases had amputation. Union was acquired in 7 (7/10) cases for grade I and 4 (4/6) cases for grade II. Two cases with severe displacement both ended in non-union. There were two local recurrences. The actual survival rate of the 13 cases with osteosarcoma was 33% in 80 months, showing significantly lower results compared to 238 contemporary cases of IIB (P=0.04) .
CONCLUSION
Conservative external immobilization and preoperative chemotherapy for pathologic fracture of primary malignant bone tumor was good initially in the care of amputation. Local recurrence rate was 11 percent and survival rate was significantly worse.