Pathological fracture from clinically occult breast cancer

Carrascosa, Miguel F; Fernández-Ayala, Marta; Hoz, Marta Cano; Carrera, Ismael Abascal; Sáenz, Elena Casuso; Montes‐Moreno, Santiago; López‐Vega, José Manuel

doi:10.1016/s1470-2045(21)00074-7

Cited by 3 publications

(2 citation statements)

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“…And old fracture refers to the fracture occurring for 3 weeks or more, which is not treated in time and usually develops into malunion, delayed union or non-union [ 10 ]. Pathological fracture refers to the fracture caused by diseases resulting in the destruction of bone tissue, bone changes, and the reduction of bone biomechanical strength [ 11 ]. Traumatic fracture is the fracture caused by direct or indirect violent trauma [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

A risk prediction model for postoperative recovery of closed calcaneal fracture: a retrospective study

Li,

Wang,

Zhang

et al. 2023

J Orthop Surg Res

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Objective To explore the risk factors for postoperative recovery of closed calcaneal fracture and develop a prediction model. Methods We retrospectively enrolled patients with closed calcaneal fracture from January 1, 2017 to December 31, 2020. Patients treated from 2017 to 2019 were selected as a training cohort and those in 2020 as a validation cohort. The outcome variable was the postoperative recovery evaluated by the Creighton-Nebraska calcaneal fracture scoring system. Multivariate logistic regression analysis was used to screen the risk factors of postoperative recovery. A risk prediction model was constructed in the training cohort and the corresponding nomogram was drawn. The model was validated internally using bootstrapping and externally by calculating the performance in the validation cohort. Results A total of 659 patients with closed calcaneal fracture met the inclusion and exclusion criteria, which were divided into the training cohort (n = 509) and the validation cohort (n = 150). 540 cases (81.9%) patients recovered well after calcaneal fracture surgery. According to multivariate logistic regression analysis, female (OR = 2.525, 95% CI 1.283–4.969), > 60 years (OR = 6.644, 95% CI 1.243–35.522), surgery within 8–14 days after fracture (OR = 2.172, 95% CI 1.259–3.745), postoperative infection (OR = 4.613, 95% CI 1.382–15.393), and weight-bearing time longer than 3 months after surgery (4–6 months, OR = 2.885, 95% CI 1.696–4.907; 7–12 months, OR = 3.030, 95% CI 1.212–7.578; > 12 months, OR = 15.589, 95% CI 3.244–74.912) were independent risk factors for postoperative recovery of calcaneal fractures. The C-indices were 0.750(95% CI 0.692–0.808) in the training cohort and 0.688(95% CI 0.571–0.804) in the external validation cohort, and the C-index of internal validation was 0.715. The Hosmer–Lemeshow test showed good fitting of the model (all P > 0.05), which was consistent with the results of the calibration plots. Decision Curve Analysis indicated that the clinical effectiveness was the best when the threshold probability was between 0.10 and 0.45. Conclusions Patients with female, > 60 years, surgery within 8–14 days after fracture, postoperative infection, and weight-bearing time longer than 3 months after surgery are more likely to have poor postoperative recovery. The risk prediction of fracture patients through this model might be translated into clinical guidance and application. Trial registration This study was registered on the Chinese Clinical Trial Registry (Registration number: ChiCTR-EPR-15005878).

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Section: Methodsmentioning

confidence: 99%

A risk prediction model for postoperative recovery of closed calcaneal fracture: a retrospective study

Li,

Wang,

Zhang

et al. 2023

J Orthop Surg Res

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“…(23,34) Radiological presentation of SM is usually in the form of lysis, although breast cancer SM are present in a blas-tic form in 20-40% of cases, and prostate cancer SM are always blastic. (9,25). An earlier standpoint was that lysis represented a higher risk for fracture (17), but recent studies showed that blastic SM also carried a high risk, especially in the proximal femur.…”

Section: Discussionmentioning

confidence: 99%

Skeletal metastases and pathological fractures of long bones

Rajković¹,

Mičeta²,

Simić³

et al. 2022

Medicinska istraživanja

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Introduction. The most common cause of pathological fractures are skeletal metastases. Ten percent of patients with diagnosed skeletal metastases will sustain a pathological fracture. Skeletal metastases can be treated by non-surgical methods, including analgesics, bisphosphonates, and radiotherapy, with the primary goal of relieving pain and slowing down tumor growth. Surgical treatment is indicated for impending or existing fractures. It includes stabilization with internal fixation using various nails, plates, and screws with or without osteoplasty, and endoprosthetic joint replacement, especially in lesions around major joints - hip, knee, and shoulder. Material and Methods. The study included patients operatively treated at the Institute of orthopedics "Banjica" and pathohistologically analyzed at the Institute of pathology in Belgrade during the period from February 2021 to January 2022. Inclusion criteria were an existing or impending pathological fracture of long bones, operative treatment with tissue sampling, and the consequent pathohistological diagnosis of metastatic carcinoma. Patients with biopsy-proven processes other than metastatic carcinomas were excluded from the study. The total number of patients included in the study was 69. Results. The mean age of patients at the pathological fracture occurrence was 67.7 (ranging from 42 to 88). Malignant diseases diagnosed were: breast cancer 36.1%, lung cancer 24.5%, kidney cancer 14.5%, prostate cancer 13.1%, colorectal cancer 2.9%, other cancer (8.9%). The radiological presentation was in the form of lysis in 75.4% and in blastic form in 24.6%. Operative treatment included arthroplasty in 53.6% of patients and stabilization with nail or plate in 46.4%. Conclusion. Pathological fractures represent the final outcome of tumor activity in a bone and cause significant suffering in patients expressed through severe pain and often immobility, which accelerates all the pathological processes and leads to death. Joint methods of contemporary chemotherapy, radiotherapy, and surgery enabled a significant life quality improvement and extension in these patients.

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Curettage of lesion combined with reconstruction of intramedullary nail and bone cement for the treatment of subtrochanteric metastatic tumors of the femur

2024

Am J Cancer Res

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Pathological fracture from clinically occult breast cancer

Cited by 3 publications

References 0 publications

A risk prediction model for postoperative recovery of closed calcaneal fracture: a retrospective study

A risk prediction model for postoperative recovery of closed calcaneal fracture: a retrospective study

Skeletal metastases and pathological fractures of long bones

Curettage of lesion combined with reconstruction of intramedullary nail and bone cement for the treatment of subtrochanteric metastatic tumors of the femur

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