Abstract
BackgroundPathologic fractures are caused by diseases that lead to weakness of the bone structure. This process sometimes occurs owing to bony change after radiation therapy. Treatment of pathologic fractures may be difficult because of previous radiation therapy.MethodsIn 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.ResultPatients received an average radiation dose of 59.2 (SD, 7.2) Gy. Four of five patients exhibited bone union regardless of whether open reduction and internal fixation (OR/IF) was performed. Patients have the potential to heal after postoperative radiation therapy. 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. OR/IF may be selected in cases of significant bone deviation, small remaining bone volume, or occlusive change.ConclusionPatients have the potential to heal after postoperative radiation therapy.
Highlights
Pathologic fractures are caused by diseases that lead to weakness of the bone structure
This type of fracture is treatable with open reduction and internal fixation (OR/IF) or closed
62 (79.5 %), patients were diagnosed with squamous cell carcinoma (SCC), six (7.6 %) with adenoid cystic carcinoma (ACC), three (3.8 %) with osteosarcoma, two (2.6 %) with malignant melanoma, two (2.6 %) with mucoepidermoid carcinoma, one (1.3 %) with fibrosarcoma, one (1.3 %) with verrucous carcinoma, one (1.3 %) with undifferentiated carcinoma
Summary
Pathologic fractures are caused by diseases that lead to weakness of the bone structure. Radiation therapy is a useful treatment for head and neck cancer; it may cause pathologic fracture, as irradiation of tissue can promote hypoxia, hypovascularity, and hypocellularity and is 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) [1,2,3,4,5] Like other fractures, this type of fracture is treatable with open reduction and internal fixation (OR/IF) or closed
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