Cláudio Beling Gonçalves Soares1, Ivana Duval de Araújo2, Bruno Jannotti Pádua3, José Carlos Souza Vilela4, Rodrigo Henriques Reis Souza3, Luiz Eduardo Moreira Teixeira5. 1. MD, Doctorate student on Surgery at the Faculty of Medicine, UFMG, Belo Horizonte, MG, Brasil. 2. Ph.D., Department of Surgery, UFMG, Belo Horizonte, MG, Brasil. 3. MD, Department of Orthopedics and Traumatology, Unimed-BH, Belo Horizonte, MG, Brasil. 4. MSc, Department of Orthopedics and Traumatology, Unimed-BH, Doctorate Student on surgery at the Faculty of Medicine, UFMG, Belo Horizonte-MG, Brasil. 5. Ph.D., Department of the Musculoskeletal System, UFMG, Belo Horizonte-MG, Brasil.
Abstract
OBJECTIVE: To evaluate the epidemiological data and available treatments for fractures secondary to radiotherapy treatment. METHODS: Identification of publications on pathological skeletal fractures previously exposed to ionizing radiation. RESULTS: The incidence of fractures after irradiation varies from 1.2% to 25% with a consolidation rate of 33% to 75%, being more frequent in the ribs, pelvis, and femur. The time elapsed between irradiation and fracture occurs years after radiotherapy. Risk factors include age above 50 years, female gender, extensive periosteal detachment, circumferential irradiation, tumor size, and anterior thigh location. The etiology is still uncertain, but cellular disappearance, reduction of bone turnover and activity were observed hematopoietic as possible causes of failure of consolidation. CONCLUSION: There is no consensus in the literature on the factors related to the development of fractures, with radiation dose, previous tumor size and periosteal detachment being suggested as potential factors.
OBJECTIVE: To evaluate the epidemiological data and available treatments for fractures secondary to radiotherapy treatment. METHODS: Identification of publications on pathological skeletal fractures previously exposed to ionizing radiation. RESULTS: The incidence of fractures after irradiation varies from 1.2% to 25% with a consolidation rate of 33% to 75%, being more frequent in the ribs, pelvis, and femur. The time elapsed between irradiation and fracture occurs years after radiotherapy. Risk factors include age above 50 years, female gender, extensive periosteal detachment, circumferential irradiation, tumor size, and anterior thigh location. The etiology is still uncertain, but cellular disappearance, reduction of bone turnover and activity were observed hematopoietic as possible causes of failure of consolidation. CONCLUSION: There is no consensus in the literature on the factors related to the development of fractures, with radiation dose, previous tumor size and periosteal detachment being suggested as potential factors.
Authors: Fei Wei; Craig J Neal; Tamil Selvan Sakthivel; Yifei Fu; Mahmoud Omer; Amitava Adhikary; Samuel Ward; Khoa Minh Ta; Samuel Moxon; Marco Molinari; Jackson Asiatico; Michael Kinzel; Sergey N Yarmolenko; Vee San Cheong; Nina Orlovskaya; Ranajay Ghosh; Sudipta Seal; Melanie Coathup Journal: Bioact Mater Date: 2022-09-21