We selected pathologic fracture patients who had received postoperative radiation therapy after cancer surgery in our department. The causes of radiation therapy were SCC, ACC, osteosarcoma, malignant melanoma, mucoepidermoid carcinoma. The initial subjects consists of 86 patients (59 males and 27 females) with an average age of 57.8 years (14~82 years) who received postoperative radiation therapy. Ī retrospective chart review with the medical records, operation notes, and radiographic data was conducted by the authors treated for patients received postoperative radiation therapy in our department from 2003 to 2013. In this study, we sought to establish indications for OR/IF and CR by examining five cases of pathologic fractures after postoperative radiation therapy. However, thus far, there has been no standard treatment protocol for pathologic fracture patients who had undergone bone postoperative radiation therapy because of a malignant tumor instead, choice of treatment has depended mainly on the experiences of the treating physician. Like other fractures, this type of fracture is treatable with open reduction and internal fixation (OR/IF) or closed reduction (CR). ![]() Radiation therapy is a useful treatment for head and neck cancer however, it may also cause pathologic fracture, as irradiation of tissue can promote hypoxia, hypovascularity, and hypocellularity and is thus associated with a number of complications, including xerostomia, loss of taste, limitation of mouth opening, progressive periodontal attachment loss, dental caries, microvascular alterations, soft tissue necrosis, pathologic fracture, and osteoradionecrosis (ORN). The reduction of bony strength may be caused by physiologic atrophy, osteoporosis, or pathologic processes (e.g., cystic lesions, malignant lesions, inflammatory conditions) or be secondary to surgical intervention. The most common etiology of a pathologic fracture is osteoradionecrosis (49 %), followed by infections (19 %) and malignancy (19 %). ![]() Patients have the potential to heal after postoperative radiation therapy.Ī pathologic fracture may occur even under, otherwise, normally tolerated loading forces when a bone has been weakened by an underlying pathologic process. OR/IF may be selected in cases of significant bone deviation, small remaining bone volume, or occlusive change. Treatment of a pathologic fracture following postoperative radiation therapy, such as traditional treatment for other types of fractures, may be performed using OR/IF or CR. Patients have the potential to heal after postoperative radiation therapy. Four of five patients exhibited bone union regardless of whether open reduction and internal fixation (OR/IF) was performed. Patients received an average radiation dose of 59.2 (SD, 7.2) Gy. In this study, we analyzed clinical and radiographic data and progress of five patients with mandibular pathological fractures who had received postoperative radiation therapy following cancer surgery. Treatment of pathologic fractures may be difficult because of previous radiation therapy. ![]() This process sometimes occurs owing to bony change after radiation therapy. Pathologic fractures are caused by diseases that lead to weakness of the bone structure.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |