Treatment of a Radiation-Associated Femur Fracture with an Intercalary Endoprosthesis: A Case Report

JBJS Case Connect. 2024 Nov 14;14(4). doi: 10.2106/JBJS.CC.23.00334. eCollection 2024 Oct 1.

Abstract

Case: A 72-year-old woman with undifferentiated pleomorphic sarcoma of the thigh received neoadjuvant chemotherapy and radiotherapy. She underwent wide resection and was scheduled for prophylactic fixation of the femur. However, prophylactic fixation was deferred secondary to COVID-19 pandemic. Unfortunately, when stepping out of an elevator, she sustained femur fracture. The fracture was treated with a cemented intercalary endoprosthesis. Three-year follow-up reveals stable fixation without any failure.

Conclusion: Postradiation fractures are challenging. Delayed union, nonunion, and infection are associated with internal fixation. To the best of our knowledge, this is the first report of intercalary endoprosthesis used for primary management of radiation-associated femur fracture.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • COVID-19
  • Female
  • Femoral Fractures* / diagnostic imaging
  • Femoral Fractures* / etiology
  • Femoral Fractures* / surgery
  • Femoral Neoplasms / radiotherapy
  • Femoral Neoplasms / surgery
  • Fracture Fixation, Internal
  • Humans
  • Radiation Injuries / etiology
  • Radiation Injuries / surgery