Which one of the benign tumors and tumor-like lesions located in long bones needs prophylactic fixation during surgery?

Abstract

Objectives: This study aims to define the simultaneous prophylactic fixation indications of benign tumors and tumor-like lesions located in long bones that were treated by curettage and grafting/cementing. Patients and methods: Fifty-six patients (33 males, 23 females; mean age 30.9±15.9; range, 15 to 65 years) who were treated by curettage and grafting or cementation for their benign tumors or tumor-like lesions in long bones between January 2013 and June 2016 were retrospectively analyzed. Age, sex, anamnesis and physical examination findings, histopathologic diagnosis, lesion localization, pre- and postoperative imaging results and follow-up data were all analyzed. The patients were divided into two groups as those with and without postoperative fracture. Results: The most common localization was femur (38%). The mean tumor diameter was 6.8±2.2 (range, 2.6 to 12.6) cm and volume was 58.3±45.0 (range, 6 to 177) cm3. Postoperative fracture occurred in 14 patients. The lesion diameter and volume of the patients in postoperative fracture group were significantly higher compared to group without postoperative fracture (p=0.034 and p=0.004, respectively). A volume value greater than 67 cm3 and ages over 35 years were found to be associated with a higher rate of fracture for all lesions. Conclusion: In the postoperative period, patients with benign tumors or tumor-like lesions of long bones had a higher fracture risk if the volume value was greater than 67 cm3 and the age was over 35 years. Prophylactic fixation may be suggested for these patients.