Role of Trauma in the Development of Malignant Bone Tumours

Primary Malignant Bone Tumours: A Retrospective Study of 869 Cases Reported to the Finnish Cancer Registry between 1962 and 1968

“…It has not been possible to demonstrate to what extent trauma may be an etiological factor in the development of primary malignant bone tumours,although some investigators are of the opinion that trauma may partly explain the greater frequency in males of such tumours (Ewing 1935, Phemister 1948, Cade 1955, Krebs et al 1963, Voutilainen etal. 1967, Fisher 1971.…”

“…In earlier literature a trauma reported by the patient has been considered an etiological factor contributing to the development of a primary malignant bone tumour (Krebs et al 1963). It has not, however, been possible to define either the mechanism of injury or the severity of the trauma with sufficient exactitude to decide whether or not it was really an etiological factor.…”

“…Present-day investigators consider trauma to be an unlikely etiological factor , Copeland 1967, van der Heul et al 1967, Fisher 1971). An attempt has been made by means of tissue cultures to determine the part played by trauma, but this was not successful (Krebs et al 1963). Trauma may cause secondary spreading of the disease by releasing malignant cells into the blood stream and lymphatic ducts, and also haematoma by means of resorption.…”

“…Trauma may cause secondary spreading of the disease by releasing malignant cells into the blood stream and lymphatic ducts, and also haematoma by means of resorption. Tissue pressure increases the development of metastases and extravasion (Krebs et al 1963). A developing tumour may cause symptoms similar to those in trauma.…”

Osteosarcoma following a fractured shaft of femur

“…In the past a causal relationship was favoured, but subsequent authors attribute it to coincidence [4,5,6,8]. Ewing wrote, "trauma reveals more malignant tumours than it causes" [5], and Krebs and Olsen described the relationship as 'traumatic determinism' [8].…”