Limb salvage surgery for pathological fractures in osteosarcoma

The local treatment of pathological fracture in patients with a primary osteosarcoma remains controversial. In this paper we report the oncological outcome of the treatment of pathological fractures in 18 patients suffering, from this disease. There were ten male and eight female patients, and the average age at diagnosis was 17 years. All patients received adjuvant chemotherapy. Wide resections were performed in 17, but in one there was 'contamination' of the margins of the excision. Skeletal reconstruction was performed with a locally designed and manufactured custom 'mega' prosthesis. The average follow-up was 33 months (range: 12-93 months), and 14 patients were alive on completion of the study. Local recurrence appeared in two patients, while three developed pulmonary metastases.