Purpose

Pathological metastatic fractures in lower-extremity weight bearing bones often require surgical reconstruction. Post-operative radiation is routinely recommended following surgical reconstruction. This study evaluated the clinical outcomes of patients that undergo surgical fixation of an established or an impending pathologic lower extremity fracture without post-operative radiation.

Materials and methods

A retrospective chart review of patients at Sunnybrook Health Sciences Center between 2007 and 2019 was performed. Descriptive statistical analyses were performed.

Results

A total of 161 surgical reconstruction procedures were identified. Among these cases, 86/161 (53.4%) received post-operative radiation, 75/161 (47%) did not receive post-operative radiation within 12 weeks of their index surgery. Of the 75 patients not receiving post-operative radiation, 40 patients had prior radiation to the surgical site and 35 patients were radiation naïve. 5 patients (6.7%) required a second operation to the index surgical site, with 4 patients (5.3%) requiring a second fixation surgery to stabilize hardware at a median of 6.0 months post-surgery. Post-surgical radiation to the surgical site (at >12 weeks) was administered to 12 patients (16.0%) at a median of 9.1 months post-surgery.

Conclusions

The surgical revision rate was low despite absence of immediate post-operative radiation therapy and was similar to prior reports in patients receiving post-operative radiation.

中文翻译：

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下肢骨转移灶术后未立即进行放射治疗而接受手术的患者的局部手术并发症发生率。

目的

下肢负重骨的病理性转移性骨折通常需要手术重建。通常建议在手术重建后进行术后放疗。本研究评估了在没有术后放疗的情况下对已确定或即将发生的病理性下肢骨折进行手术固定的患者的临床结果。

材料和方法

对 2007 年至 2019 年间 Sunnybrook 健康科学中心的患者进行了回顾性图表审查。进行了描述性统计分析。

结果

共确定了 161 例外科重建手术。在这些病例中，86/161 (53.4%) 例接受了术后放疗，75/161 (47%) 例在首次手术后 12 周内未接受术后放疗。在未接受术后放疗的 75 名患者中，40 名患者在手术部位接受过放射治疗，35 名患者未接受过放射治疗。5 名患者 (6.7%) 需要对指数手术部位进行第二次手术，4 名患者 (5.3%) 需要进行第二次固定手术以在术后 6.0 个月内稳定硬件。12 名患者 (16.0%) 在中位手术后 9.1 个月内对手术部位（>12 周）进行了术后放射治疗。

结论

尽管没有立即进行术后放射治疗，但手术翻修率很低，并且与接受术后放射治疗的患者的先前报告相似。