$non pathological fracture$

$non pathological fracture$

Ī pathological fracture of the proximal femur poses particular problems, because the fracture haematoma (which has to be considered to contain tumour cells) may either be intracapsular, thus contaminating the hip joint, or extracapsular when there is likely to be widespread contamination of surrounding tissues. The presence of a pathological fracture has been noted to be an adverse prognostic factor in osteosarcoma by some authors but not by others. Progressive loss of bone matrix, biopsy, and minor trauma are some of the reasons for the occurrence of a pathological fracture. Pathological fracture can be the presenting feature or it can occur during treatment. There are many reports on osteosarcoma and pathological fracture, most of these reports only dealing with patients without metastases at diagnosis. The incidence of pathological fracture in osteosarcoma is from 5% to 12%. 70% of all osteosarcomas will arise around the knee, but 5-6% arise in the proximal femur. Osteosarcoma is the commonest primary bone sarcoma arising with an incidence of approximately 3 per million population/year. Review of multicentre data may suggest an optimum treatment for this patient group. The high incidence of metastases both at diagnosis and subsequently suggests this group of patients are at very high risk. These results are significantly worse than expected, and it proved impossible to identify any group who fared well. The estimated five-year survival was 14%.

$non pathological fracture$

Chemotherapy was used when appropriate and eight patients then underwent limb salvage surgery, six had an amputation, and three had palliative treatment. Five patients were referred after internal fixation of the fracture prior to diagnosis. Seven patients had metastatic disease at diagnosis. Twelve patients had a fracture at diagnosis and five developed a fracture after the diagnosis. Their age range was from 9 to 84 (mean age 42) with nine patients under the age of 40 and eight above the age of 40.

$non pathological fracture$

Seventeen patients underwent treatment for a pathological fracture of the proximal femur due to osteosarcoma.

$non pathological fracture$

Non pathological fracture