ABSTRACT
BACKGROUND: Malignant bone tumors should be treated within interdisciplinary treatment concepts. The prognosis of pathological fractures is on the whole relatively poor because the fracture is indicative of a large and highly aggressive tumor and the hematoma associated with the fracture could possibly result in spreading of the tumor into the surrounding soft tissues. OBJECTIVES: This article summarizes the current interdisciplinary treatment concepts under special consideration of pathological fractures in primary bone tumors. METHODS: A selective literature search was carried out taking own experience into consideration. RESULTS: Due to the multimodal therapy approach for osteosarcoma and Ewing's sarcoma, the 5-year survival rate could be increased to 60-70 %. CONCLUSION: The therapeutic treatment should always be carried out within the framework of an interdisciplinary, oncological bone expert team, especially in cases of pathological fractures of malignant bone tumors.
Subject(s)
Bone Neoplasms/surgery , Fracture Fixation/methods , Fractures, Bone/surgery , Fractures, Spontaneous/surgery , Osteosarcoma/surgery , Osteotomy/methods , Patient Care Team , Bone Neoplasms/complications , Bone Neoplasms/diagnosis , Combined Modality Therapy/methods , Fracture Fixation/instrumentation , Fractures, Bone/etiology , Fractures, Spontaneous/etiology , Humans , Osteosarcoma/complications , Osteosarcoma/diagnosis , Osteotomy/instrumentation , Plastic Surgery Procedures/instrumentation , Plastic Surgery Procedures/methodsABSTRACT
In contrast to the standard therapy of flexor tendon injuries in adults, the postoperative treatment program for children remains a controversial topic. Some prefer immobilization therapy in a variety of forms and for different periods of time. Others prefer early mobilization programs. We present results for twenty-eight children with thirty-seven flexor tendon injuries. The average age was 5.8 years. After primary tendon suture in children six years and younger (group A), our postoperative program consisted of immobilization for three weeks. The older children (group B) were treated with an early passive mobilization program. Follow-up examinations were carried out on twenty six of the children at three months and at 3.7 years. Three months after surgery, the children in group A showed only average results while those in group B presented good finger motion. After 3.7 years both groups showed good results.
