Consequences and prevention of inadvertent internal fixation of primary osseous sarcomas

Sheila A Conway, Benjamin K. Potter, Zakariah Mahmood, J. David Pitcher, H. Thomas Temple

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

The evaluation and treatment of aggressive bone tumors continue to be diagnostic and therapeutic challenges for orthopaedic surgeons. Despite compelling data regarding the hazards of biopsy, incomplete preoperative evaluation, inappropriate biopsy techniques, and premature surgical interventions continue to compromise optimal treatment of primary bone sarcomas. We retrospectively identified eight patients who had internal fixation of a primary bone sarcoma before referral to an orthopaedic oncology service. Six of the eight patients subsequently underwent amputations and two patients underwent limb salvage for local disease control. Biopsy techniques from referring institutions were highly variable, with only two of seven rendering an accurate diagnosis. The average Musculoskeletal Tumor Society functional score was 10.6 and four of eight patients were disease-free and alive at a minimum followup of 8 months (mean, 26.9 months; range, 8-80 months). Implant violation of primary bone malignancies was associated with frequent high-level amputation for local disease control and low Musculoskeletal Tumor Society functional scores. Common errors in the initial evaluation and treatment included inadequate attention to patient history, incomplete radiographic evaluation, and improper biopsy and surgical techniques, which violated compartmental boundaries. Level of Evidence: Level IV, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Original languageEnglish
Pages (from-to)519-525
Number of pages7
JournalClinical Orthopaedics and Related Research
Volume467
Issue number2
DOIs
StatePublished - Feb 1 2009

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Sarcoma
Biopsy
Bone and Bones
Amputation
Neoplasms
Limb Salvage
Therapeutics
Orthopedics
Referral and Consultation
Guidelines

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Consequences and prevention of inadvertent internal fixation of primary osseous sarcomas. / Conway, Sheila A; Potter, Benjamin K.; Mahmood, Zakariah; Pitcher, J. David; Thomas Temple, H.

In: Clinical Orthopaedics and Related Research, Vol. 467, No. 2, 01.02.2009, p. 519-525.

Research output: Contribution to journalArticle

Conway, Sheila A ; Potter, Benjamin K. ; Mahmood, Zakariah ; Pitcher, J. David ; Thomas Temple, H. / Consequences and prevention of inadvertent internal fixation of primary osseous sarcomas. In: Clinical Orthopaedics and Related Research. 2009 ; Vol. 467, No. 2. pp. 519-525.
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