• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.44-51
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• 2009

Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.87-90
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• 2011

Osteoblastoma is rare, benign, bone-forming tumor that often occur in the spine. There are few reports of osteoblastomas resulting in pathologic fractures involving long bones. Authos report a unique case of a pathologic fracture due to an osteoblastoma of the humerus shaft. The tumor was treated successfully by curettage, intramedullary nailing and bone allograft.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.58-64
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• 2011

Purpose: The purpose of this study is to observe unicameral bone cyst (UBC) outcome after the fracture has healed and if there is any identifiable prognostic factors. Materials and Methods: 13 UBC patients with pathologic fracture from 2001 to 2010 were reviewed. The mean follow up were 26 months (3-90 months). There were 11 male and 2 female patients and the mean age of the patients were 10.2 years old (6-16 years). 9 involved proximal humerusand 2 involved humerus shaft and 1 involved proximal femur and 1 involved proximal tibia. The treatment of UBC fracture was conservative cast application to heal the fracture initially, and 1 patient was treated with primary auto bone graft and open reduction with internal fixation. 5 patients were treated with steroid injection during follow up period and 2 patients with auto bone graft. We analyzed the change of UBC during pathologic fracture healing period and prognostic factor about age, the size of UBC, the involvement of physis. Results: The mean duration of the fracture healing was 8.2 months. Complete healing were occurred at 4 patients (31%). No statiscal difference was checked with age about UBC healing (p=0.42). But, more larger size about UBC and more closer to physis, the healing was difficult (p=0.05, p=0.03). Conclusion: While pathologic fracture of UBC was possibly healed, active treatment should be applied especially those cysts that involvescloser area of the physis or large size.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.195-195
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• 2009

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.1-11
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• 2003

Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.38-44
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• 2003

Purpose: To suggest an appropriate treatment modality regarding analyze outcomes of treatment for pathologic fracture to simple bone cyst of the long bone. Materials and Methods: We selected 12 cases with pathologic fracture of the long bone among the 31 cases treated for simple bone cyst from December. 1993 to May. 2001. The mean age was 9 years ranged from 2 years to 19 years, male was 11 cases and female was 1 cases, and the mean follow up interval was 32.9 month ranged from 12 month to 69 month. The principle of treatment for pathologic fracture of the long bone was conservative treatment except operative treatment for fracture with displacement of the femur. After fracture was united, the residual lesion was treated by local steroid injection, cortical drilling, curettage & bone graft. But we observed without specific treatment in cases that had healing process of simple bone cyst followed by bony union. The clinical results were evaluated as exellent if simple bone cyst was completely healed, as good if that had process of healing, as poor if that was no change or more increased in size. Results: The pathologic fracture was united in all cases treated with conservative treatment in 9cases and by open reduction with internal fixation in 3 cases. After fracture was united, the 6 cases were observed without specific treatment, because they had healing process of cyst, and had outcomes as good and excellent. Conclusion: We suggest to need observation when simple bone cyst has healing process after pathologic fracture was united, otherwise secondary treatment will be needed when residual lesion is persisted.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.111-117
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• 2005

Purpose: We evaluate the results of treatment of pathologic femur fractures secondary to bone tumors in children. Materials and Methods: Between January 1995 and June 2004, 18 patients(20 cases) were evaluated. Their mean age of the first episode of fracture was 10.2 years and mean follow-up period is 42.5 months. Primary bone tumors, the location of fracture, time to union and complications were evauated. Results: Fractures occurred at proximal portion in 14 cases, shaft 3 cases and distal portion 3 cases. The bone tumors causing pathologic fracture were fibrous dysplasia(9 c ases), simple bone cyst(4 cases), aneurysmal bone cyst(4 cases), nonossifying fibroma(2 cases) and eosinophilic granuloma(1 case). In the treatment for fractures, cast was in 11 cases, internal fixation 8 cases and external fixation in 1 case. In the treatment for tumors, observation was in 11 cases, curettage & bone graft in 8 cases and resection in 1 case. In polyostotic fibrous dysplasia, all cases were treated by cast initially but deformity developed in all cases. Fracture prevention and deformity correction were obtained with intramedullary nailing. Conclusion: Adequate choice of treatment of bone tumor and fracture will result in good prognosis.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.90-94
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• 2020

Percutaneous balloon kyphoplasty is an option for pain relief in pathological vertebral compression fractures. Complications related to cement leakage through cortical defects have been reported. On the other hand, dural compression due to retropulsion of the tumor mass is rarely reported. The authors report a case of a 65-year female patient who had cauda equina syndrome after a percutaneous balloon kyphoplasty in a pathological vertebral fracture, even though epidural compression were not found prior to surgery. Magnetic resonance imaging revealed retropulsion of the tumor mass into the spinal canal through the disrupted posterior vertebral cortex.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.2
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• pp.80-86
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• 2010

Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

• The Journal of the Korean bone and joint tumor society
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• v.19 no.2
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• pp.78-82
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• 2013

Langerhans cell histiocytosis is known as one of the diseases related to excessive proliferation of normal monocytes and has the variety of clinical courses and treatment. Especially, in cases with the spine, it shows a feature of single or multiple osteolysis. According to the location, disease progression and concomitant symptom, variety of treatments (observation, radiotherapy, chemotherapy, surgery, etc.) have been attempted, however, appropriate treatment has not been established yet. The authors introduce the case of single system Langerhans cell histiocytosis which involves cervical and lumbar vertebrae simultaneously with bone marrow destruction and pathologic fracture.