Femoral fracture in primary soft-tissue sarcoma of the thigh treated with radiation therapy: indications for prophylactic intramedullary nail View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-07-23

AUTHORS

Andrea Sambri, Lorenzo Gardini, Mattia Dalla Rosa, Guido Zavatta, Mert Keskinbora, Cristina Ferrari, Davide Maria Donati, Giuseppe Bianchi

ABSTRACT

IntroductionPost-radiation fractures of the femur (PRF) are difficult to treat and are associated with a high risk of delayed union and non-union. We report a series of patients affected by soft tissue sarcoma (STS) of the thigh, treated with limb-sparing surgery and perioperative radiotherapy (RT), to analyse post-radiotherapy femur fracture (FF) rate and its management. Material and methods547 patients treated with surgery and RT for a deep primary STS of the thigh were included. “Periosteal stripping” and “bone tangential resection” were performed in case of tumor invasion. In the case of complete bone involvement, the patient received its complete resection and econstruction. ResultsTwenty-three (4.3%) patients underwent surgical procedures involving periosteum and cortical bone. In 11 (2.0%) patients a bone resection was required because of massive bone involvement. Six out of these 11 (54.5%) patients developed major complications (infection and aseptic loosening). At the time of STS excision, 11 patients (2.0%) underwent prophylactic intramedullary nailing (PIN). PRF occurred in 15 patients (3.0%) at a median follow up of 52 months (range 3–151). Among patients who developed PRF, three were treated with a prosthesis (no complications) and eight nailing (7/8, 87.5% did not heal and developed a non-union).ConclusionsGiven the potentially devastating complication of a PRF, PIN should be considered. We suggest prophylactic IM nail in patients at higher risk the time of STS excision. In other cases, IM nail can be postponed in the following years considering the prognosis. More... »

PAGES

1277-1282

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00402-020-03544-x

DOI

http://dx.doi.org/10.1007/s00402-020-03544-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1129604539

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32705383


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