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

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Celik A.
Erdogan O.
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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.
Tıp, Dahili Tıp Bilimleri, İç Hastalıkları, Yoğun Bakım, Cerrahi Tıp Bilimleri, Acil Tıp, Ortopedi ve Travmatoloji, Sağlık Bilimleri, Medicine, Internal Medicine Sciences, Internal Diseases, Intensive Care, Surgery Medicine Sciences, Emergency Medicine, Orthopedics and Traumatology, Health Sciences, YOĞUN BAKIM, Klinik Tıp, Klinik Tıp (MED), ACİL TIP, ORTOPEDİ, CERRAHİ, CRITICAL CARE MEDICINE, CLINICAL MEDICINE, Clinical Medicine (MED), EMERGENCY MEDICINE, ORTHOPEDICS, SURGERY, Ayak Bakımı, Acil Tıp Hizmetleri, Cerrahi, Ortopedi ve Spor Hekimliği, Yoğun Bakım Tıbbı, Podiatry, Emergency Medical Services, Surgery, Orthopedics and Sports Medicine, Critical Care and Intensive Care Medicine, Pathological fracture, Misdiagnosis, Neglected, Malign bone lesion, Sarcoma, METASTASES, FEATURES
DEMİRÖZ S., ÖKTEM F., Celik A., Erdogan O., ÖZKAN K., GÜRKAN V., "Evaluation of patients with pathological fractures treated by standard trauma principles but neglecting the underlying malign bone disease", INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, cilt.53, sa.11, ss.3736-3741, 2022
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