Volume 2 | Issue 2 | May-Aug 2016 | Page 10-12 | Zeeshan Khan1, Shakir Hussain1, Simon Carter1<\/p>\n
[1] The Bone and soft tissue tumour unit,
\nThe Royal Orthopaedic Hospital, Birmingham, UK. B31 2AP.<\/p>\n
Address of Correspondence<\/strong> Introduction:<\/strong> Osteosarcoma is the commonest primary bone tumour with a bimodal age distribution. The survivorship of patients with osteosarcoma has improved with advances in chemotherapy making limb salvage surgery the commonest surgical procedure. Pathological fractures associated with osteosarcoma, however are rare and suggests the aggressiveness of the tumour. These patients are considered as a special group due to the variable outcomes reported in the literature due to some special characteristics, prompting the discussion between limb salvage surgery versus ablative surgery. Introduction<\/strong><\/span>
\nDr. Zeeshan Khan
\nBone tumour unit, The royal orthopaedic hospital, Birmingham, UK. B31 2AP.
\nEmail: zeek1978@yahoo.co.uk<\/p>\n
\nAbstract<\/span><\/h3>\n
\nThis article reviews the reasons why this group of patients are considered challenging and also the various outcomes reported in the literature.
\nKeywords:<\/strong> Pathological fracture, osteosarcoma, outcomes<\/p>\n
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\nPrimary bone and soft tissue sarcomas are rare tumours. Osteosarcoma is the commonest primary bone tumour with a bimodal age distribution and with a reported incidence of 2-3 per million population per year [1, 2]. With advances in chemotherapy, the survivorship of patients with osteosarcoma has improved significantly with various studies revealing similar results with limb salvage surgery when compared with amputation [5]. Contra indications to limb salvage surgery may include involvement of the neurovascular bundle, joint involvement, progression of disease whilst on treatment, patient choice, infection and a pathological fracture (Figure 1).
\nA pathological fractureassociated with osteosarcoma at presentation or during treatment is even rarer with a reported incidence of 5-10% [3, 4].A pathological fracture can be the mode of presentation for osteosarcomas in certain cases whereas it can occur during treatment in others. This is generally considered to be an aggressive biological behaviour of the disease which in turn, historically, has been considered as a poor prognostic factor in the outcome of this special group of patients [6].<\/p>\n