The surgical treatment of patients with osteosarcoma who sustain a pathologic fracture

Sean P. Scully, H. Thomas Temple, Regis J. O'Keefe, Henry J. Mankin, Mark Gebhardt

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

The presence of pathologic fracture in osteosarcoma raises concerns of tumor dissemination by the fracture hematoma and has been considered a contraindication to limb salvage surgery. Because this is a theoretical concern, there are little clinical data available in the literature on which to base treatment of these patients. Eighteen patients with osteosarcoma who sustained a pathologic fracture and had a minimum of 24 months of followup were reviewed retrospectively. Surgical treatment included nonoperative therapy, amputation, and limb salvage groups. Patients who refused surgical intervention (2) had a uniformly poor outcome. Patients who underwent amputation (6) had no local recurrences and 33% developed metastases. Patients who underwent limb salvage (10) experienced 3 local recurrences and 6 distant recurrences. Although the distant recurrence rate for patients undergoing amputation was no different from the rate for those undergoing limb salvage, the difference in local tumor control approached statistical significance. All patients who developed local recurrence died. Surgical treatment needs to be individualized and based on factors such as fracture displacement, stability, radiographic and histologic response to chemotherapy, and the perceived ability to resect the fracture hematoma completely.

Original languageEnglish
Pages (from-to)227-232
Number of pages6
JournalClinical Orthopaedics and Related Research
Issue number324
StatePublished - Mar 13 1996
Externally publishedYes

Fingerprint

Spontaneous Fractures
Osteosarcoma
Limb Salvage
Recurrence
Amputation
Hematoma
Therapeutics
Neoplasms
Neoplasm Metastasis
Drug Therapy

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Scully, S. P., Thomas Temple, H., O'Keefe, R. J., Mankin, H. J., & Gebhardt, M. (1996). The surgical treatment of patients with osteosarcoma who sustain a pathologic fracture. Clinical Orthopaedics and Related Research, (324), 227-232.

The surgical treatment of patients with osteosarcoma who sustain a pathologic fracture. / Scully, Sean P.; Thomas Temple, H.; O'Keefe, Regis J.; Mankin, Henry J.; Gebhardt, Mark.

In: Clinical Orthopaedics and Related Research, No. 324, 13.03.1996, p. 227-232.

Research output: Contribution to journalArticle

Scully, SP, Thomas Temple, H, O'Keefe, RJ, Mankin, HJ & Gebhardt, M 1996, 'The surgical treatment of patients with osteosarcoma who sustain a pathologic fracture', Clinical Orthopaedics and Related Research, no. 324, pp. 227-232.
Scully SP, Thomas Temple H, O'Keefe RJ, Mankin HJ, Gebhardt M. The surgical treatment of patients with osteosarcoma who sustain a pathologic fracture. Clinical Orthopaedics and Related Research. 1996 Mar 13;(324):227-232.
Scully, Sean P. ; Thomas Temple, H. ; O'Keefe, Regis J. ; Mankin, Henry J. ; Gebhardt, Mark. / The surgical treatment of patients with osteosarcoma who sustain a pathologic fracture. In: Clinical Orthopaedics and Related Research. 1996 ; No. 324. pp. 227-232.
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