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Treatment of a Radiation-Associated Femur Fracture with an Intercalary Endoprosthesis: A Case Report
Joshua D Johnson1, Humaid Al Farii2, Valerae O Lewis3
1Sanford University of South Dakota Medical Center, Department of Orthopedics and Sports Medicine, Sioux Falls, South Dakota.
Case:
A 72-year-old woman with undifferentiated pleomorphic sarcoma of the thigh received neoadjuvant chemotherapy and radiotherapy. She underwent wide resection and was scheduled for prophylactic fixation of the femur. However, prophylactic fixation was deferred secondary to COVID-19 pandemic. Unfortunately, when stepping out of an elevator, she sustained femur fracture. The fracture was treated with a cemented intercalary endoprosthesis. Three-year follow-up reveals stable fixation without any failure.
Conclusion:
Postradiation fractures are challenging. Delayed union, nonunion, and infection are associated with internal fixation. To the best of our knowledge, this is the first report of intercalary endoprosthesis used for primary management of radiation-associated femur fracture.
