Limb salvage surgery for pathological fractures in osteosarcoma

Area of Science:

• Orthopedic Oncology
• Skeletal Reconstruction
• Osteosarcoma Research

Background:

• Pathological fractures in primary osteosarcoma present complex treatment challenges.
• The optimal local management strategy for these fractures remains debated.
• Effective treatment is crucial for patient survival and limb salvage.

Purpose of the Study:

• To evaluate the oncological outcomes of treating pathological fractures in primary osteosarcoma patients.
• To assess the efficacy of wide resections and custom mega prostheses in this cohort.
• To report local recurrence and distant metastasis rates following surgical intervention.

Main Methods:

• Retrospective analysis of 18 patients with primary osteosarcoma and pathological fractures.
• All patients received adjuvant chemotherapy.
• Surgical treatment involved wide resections (17/18) and reconstruction with custom mega prostheses.

Main Results:

• 14 out of 18 patients were alive at an average follow-up of 33 months.
• Local recurrence was observed in 2 patients.
• Pulmonary metastases developed in 3 patients.

Conclusions:

• Local treatment of pathological fractures in osteosarcoma using wide resection and custom mega prostheses can achieve favorable oncological results.
• This approach appears to offer a viable option for managing complex fractures in osteosarcoma.
• Further research with longer follow-up is warranted to confirm these findings.