Evaluation of patients with pathological fractures treated by standard trauma principles but neglecting the underlying malign bone disease

DEMİRÖZ S., ÖKTEM F., Celik A., Erdogan O., ÖZKAN K., GÜRKAN V.

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, vol.53, no.11, pp.3736-3741, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 53 Issue: 11
  • Publication Date: 2022
  • Doi Number: 10.1016/j.injury.2022.08.052
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Abstracts in Social Gerontology, Aerospace Database, CINAHL, Communication Abstracts, EMBASE, MEDLINE, Metadex, SportDiscus, Civil Engineering Abstracts
  • Page Numbers: pp.3736-3741
  • Keywords: Pathological fracture, Misdiagnosis, Neglected, Malign bone lesion, Sarcoma, METASTASES, FEATURES
  • Bezmialem Vakıf University Affiliated: Yes


Introduction: There are several studies in the literature about pathological fractures but almost no in-formation about patients whose pathological fracture caused by a malignant lesion misdiagnosed and treated as a simple fracture. The aim of this study was to investigate patient and fracture characteristics, and outcomes in cases where fractures occurred in the presence of a malign pathology but were treated as simple fractures. Patients andMethods: Cases of malign bone lesions between 20 0 0 and 2020 were retrospectively re-viewed. Patients with a final diagnosis of malign bone lesion but whose pathological fractures were treated ignoring the underlying malign bone disease were included. Demographic, clinical and outcome data were collected from patient's medical records and analyzed.Results: Six patients met the inclusion criteria. Three of the patients were female and the cohort mean age was 56.8 +/- 21.8 years at the time of admission. Patient diagnoses were: renal cell carcinoma metas-tasis ( n = 1); colon cancer metastasis ( n = 1); chondrosarcoma ( n = 2); osteosarcoma ( n = 1); and undif-ferentiated pleomorphic sarcoma of bone ( n = 1). In all cases surgical management differed from those that should have been applied if the pathological fracture had been identified. Furthermore, surgical man-agement after definitive histological diagnosis were more aggressive compared to if the malignancy had been identified at first admission. All patients died after a mean follow-up of 16.67 +/- 11.7 months and the complication rate was 100%.Conclusion: When a pathological fracture is misdiagnosed and managed as a simple bone fracture, out-comes are extremely poor. In these situations, remedial surgery is more extensive, with increased com-plication rates and there is poor life expectancy.(c) 2022 Elsevier Ltd. All rights reserved.