{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T20:28:13Z","timestamp":1767990493432,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,12,31]],"date-time":"2012-12-31T00:00:00Z","timestamp":1356912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pathological fracture is an uncommon presentation in patients with long bone osteosarcoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedures<\/jats:title><jats:p>We retrospectively reviewed the database of all patients with histologically proven osteosarcoma under the age of 18 years from 1991 to 2011 in a tertiary pediatric oncology referral center. Five patients with pathological fractures as the first presentation of osteosarcoma were identified. The treatment strategies and complications were evaluated. Ten sex\u2010, age\u2010, and site\u2010 matched osteosarcoma patients without pathological fracture were selected as controls. The incidence of distant metastases and outcome, including local recurrence and survival, were compared between the index (with pathological fracture) and the control (without pathological fracture) groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the index group, all five patients were boys and the mean age of onset was 13.1 years (range 9.2\u201314.9). Three patients (60%, 3\/5) received amputation and two (40%) had wide local excision of the tumor. Pathological fracture group showed higher rate of lung (60% vs. 10%, <jats:italic>P<\/jats:italic>\u2009=\u20090.04) and bone (60% vs. 10%, <jats:italic>P<\/jats:italic>\u2009=\u20090.04) metastases at presentation, and shorter overall 5\u2010year survival (<jats:italic>P<\/jats:italic>\u2009=\u20090.04) than the control group. There was no significant difference of local recurrence (20%, <jats:italic>P<\/jats:italic>\u2009=\u20091.00) between these two groups regardless of the type of operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Osteosarcoma complicated by pathological fracture as first presentation had higher incidence of lung and bone metastases at presentation and worse survival rate when compared with patients without pathological fracture. Pediatr Blood Cancer 2013; 60: 1118\u20131121. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.24447","type":"journal-article","created":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T20:16:00Z","timestamp":1357071360000},"page":"1118-1121","source":"Crossref","is-referenced-by-count":18,"title":["Pathological fracture as the presenting feature in pediatric osteosarcoma"],"prefix":"10.1002","volume":"60","author":[{"given":"Ryan K.L.","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winnie C.W.","family":"Chu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce H.Y.","family":"Leung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frankie W.T.","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.K.","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,12,31]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2011.02.007"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2007.07.018"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.07.040"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/512389"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002640000143"},{"key":"e_1_2_5_7_2","first-page":"556","article-title":"Diaphyseal sclerotic osteosarcoma presenting as a pathological fracture","volume":"74","author":"Sen RK","year":"2008","journal-title":"Acta Orthop Belg"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2007.07.004"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199603000-00028"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200201000-00008"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/107327480501200107"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/00016470310017776"},{"key":"e_1_2_5_13_2","first-page":"1730","article-title":"The surgical treatment and outcome of nonmetastatic osteosarcoma of the extremity with pathologic fractures","volume":"46","author":"Niu XH","year":"2008","journal-title":"Zhonghua Wai Ke Za Zhi"},{"key":"e_1_2_5_14_2","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1302\/0301-620X.78B5.0780694","article-title":"The surgical treatment and outcome of pathological fractures in localised osteosarcoma","volume":"78","author":"Abudu A","year":"1996","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_2_5_15_2","first-page":"351","article-title":"Conservative surgery as an alternative treatment of a knee osteosarcoma in the presence of a pathological fracture","volume":"23","author":"P\u00e9rez Serna AG","year":"2009","journal-title":"Acta Ortop Mex"},{"key":"e_1_2_5_16_2","first-page":"30","article-title":"The effect of limb salvage on treating osteosarcoma with pathological fracture in two cases","volume":"20","author":"Li D","year":"2006","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001040051188"},{"key":"e_1_2_5_18_2","first-page":"251","article-title":"Management problems in the diagnostic work\u2010up and treatment of pathological fracture of the proximal femur. Clinical case report","volume":"109","author":"Sass M","year":"2006","journal-title":"Unfallchirurg"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-5-198"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.24447","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.24447","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.24447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T08:04:08Z","timestamp":1700640248000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.24447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12,31]]},"references-count":18,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2013,7]]}},"alternative-id":["10.1002\/pbc.24447"],"URL":"https:\/\/doi.org\/10.1002\/pbc.24447","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12,31]]}}}