Pathological fractures in primary bone sarcomas.

Injury. 2008 Apr;39(4):395-403. Epub 2007 Dec 3.
Papagelopoulos PJ, Mavrogenis AF, Savvidou OD, Benetos IS, Galanis EC, Soucacos PN.

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Pathological fractures in patients with primary bone sarcomas should not be considered an absolute indication for amputation. Initial fracture management should include cast immobilisation or external fixation avoiding tumour-cell dissemination. The extent of fracture displacement and the type of fracture stabilisation may affect the outcome of patients with primary bone sarcomas presenting with pathological fractures. Patients with high-grade primary bone sarcomas should be treated by neo-adjuvant chemotherapy, and limb-salvage surgery. Pathological fractures in chemo-resistant primary bone sarcomas are a relative contraindication for limb salvage surgery.