Fractures following limb-salvage surgery and adjuvant irradiation for
soft-tissue sarcoma. Bell-RS; O'Sullivan-B; Nguyen-C; Mahoney-J; Langer-F; Cummings-B; Czitrom-A; Catton-C University Muscoloskeletal Oncology Unit, Mt. Sinai Hospital, Toronto, Ontario, Canada. Clin-Orthop. 1991 Oct(271): 265-71 In a prospective study, consecutive patients were treated for soft-tissue sarcoma (STS) by wide resection and adjuvant irradiation. Twelve patients had resection of bone to achieve a tumor free margin; five of these patients were left with lower extremity open segmental cortical defects in the high-dose radiation field. Four of the five patients with cortical defects suffered a fracture through the defect more than six months after surgery. Only one of 71 patients not treated with bony resection suffered a late fracture. Patients requiring bony cortex resection for STS of the lower extremity should be considered at risk for late fracture if adjuvant irradiation is prescribed.
Original Text by Clifford R. Wheeless, III, MD.
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