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Updated: Aug 14, 2026
10:08
Pseudofracture: An Acute Peripheral Tissue Trauma Model
Published on: April 18, 2011
Pathologic fractures after surgery and radiation for soft tissue tumors
C S Helmstedter1, M Goebel, R Zlotecki
1Department of Orthopedic Surgery, Southern California Kaiser Permanente, Baldwin Park, USA.
Clinical Orthopaedics and Related Research
|August 15, 2001
Summary
Pathologic fractures are a risk after soft tissue tumor treatment, especially in the thigh. Consider prophylactic fixation for high-risk patients to prevent complications like nonunion.
Area of Science:
- Orthopedic Oncology
- Musculoskeletal Oncology
- Radiation Oncology
Background:
- Pathologic fractures can occur in patients treated for soft tissue tumors.
- Understanding risk factors is crucial for preventing these fractures and improving patient outcomes.
Purpose of the Study:
- To identify risk factors for pathologic fractures in patients with soft tissue tumors treated with radiation and surgery.
- To evaluate the incidence and characteristics of these fractures, particularly in the thigh.
Main Methods:
- Retrospective review of 285 patients treated for soft tissue tumors.
- Analysis of fracture incidence, timing, and associated risk factors, including tumor location, surgical approach, and radiation parameters.
Main Results:
- Twenty pathologic fractures occurred in 285 patients; 12 occurred in 11 patients with thigh tumors.
- Fractures occurred a mean of 40.5 months post-treatment and were linked to anterior thigh location, extensive periosteal stripping, and marginal resection.
- Radiation therapy parameters were not associated with fracture risk. High complication rates (45% nonunion, 20% infection) were observed.
Conclusions:
- Tumor location in the anterior thigh, extensive periosteal stripping, and marginal resection are significant risk factors for pathologic fractures.
- Prophylactic intramedullary fixation of the femur should be considered for high-risk patients undergoing resection of large anterior thigh tumors with adjuvant radiation.
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