{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:48:11Z","timestamp":1792813691092,"version":"4.5.0"},"reference-count":20,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"8","license":[{"start":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T00:00:00Z","timestamp":1375315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:p>We investigated the clinical outcome of internal fixation for pathological fracture of the femur after primary excision of a soft-tissue sarcoma that had been treated with adjuvant radiotherapy.<\/jats:p>\n                  <jats:p>A review of our database identified 22 radiation-induced fractures of the femur in 22\u00a0patients (seven men, 15 women). We noted the mechanism of injury, fracture pattern and any complications after internal fixation, including nonunion, hardware failure, secondary fracture or deep infection.<\/jats:p>\n                  <jats:p>The mean age of the patients at primary excision of the tumour was 58.3 years (39 to 86). The mean time from primary excision to fracture was 73.2 months (2 to 195). The mean follow-up after fracture fixation was 65.9 months (12 to 205). Complications occurred in 19\u00a0patients (86%). Nonunion developed in 18 patients (82%), of whom 11 had a radiological nonunion at 12 months, five a nonunion and hardware failure and two an infected nonunion. One patient developed a second radiation-associated fracture of the femur after internal fixation and union of the initial fracture. A total of 13 patients (59%) underwent 24 revision operations.<\/jats:p>\n                  <jats:p>Internal fixation of a pathological fracture of the femur after radiotherapy for a soft-tissue sarcoma has an extremely high rate of complication and requires specialist attention.<\/jats:p>\n                  <jats:p>Cite this article: Bone Joint J 2013;95-B:1144\u20138.<\/jats:p>","DOI":"10.1302\/0301-620x.95b8.31832","type":"journal-article","created":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T05:17:21Z","timestamp":1375334241000},"page":"1144-1148","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":39,"title":["Internal fixation of radiation-induced pathological fractures of the femur has a high rate of failure"],"prefix":"10.1302","volume":"95-B","author":[{"given":"A.","family":"Sternheim","sequence":"first","affiliation":[{"name":"Mount Sinai Hospital, 600\rUniversity Ave, Toronto, Ontario, M5G\r1X5, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Saidi","sequence":"additional","affiliation":[{"name":"Northern Ontario School Of Medicine, 2120\rRegent Street South, Unit 2, Sudbury, Ontario, P3E\r3Z9, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Lochab","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital, 600\rUniversity Ave, Toronto, Ontario, M5G\r1X5, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. W.","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Markey Cancer Center, University\rof Kentucky, Lexington, Kentucky\r40536, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. C.","family":"Eward","sequence":"additional","affiliation":[{"name":"Duke Cancer Center, Duke\rUniversity, Durham, North\rCarolina 27710, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital, 600\rUniversity Ave, Toronto, Ontario, M5G\r1X5, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. S.","family":"Wunder","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital, 600\rUniversity Ave, Toronto, Ontario, M5G\r1X5, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital, 600\rUniversity Ave, Toronto, Ontario, M5G\r1X5, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"r1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09292-9"},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27639"},{"key":"r3","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198209000-00009"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.1.197"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9098(199602)61:2<90::AID-JSO2>3.0.CO;2-M"},{"key":"r6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.02.001"},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2004.12.020"},{"key":"r8","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-006-9028-6"},{"key":"r9","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22298"},{"key":"r10","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19980615)82:12<2356::AID-CNCR9>3.0.CO;2-Q"},{"key":"r11","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.C.01714"},{"key":"r12","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24949"},{"key":"r13","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1405-6"},{"key":"r14","doi-asserted-by":"crossref","unstructured":"Nicholls F, Janic K, Filomeno P, et al.\n                      Effects of radiation and surgery on healing of femoral fractures in a rat model.\n                      J Orthop Res\n                      2013:Epub.","DOI":"10.1002\/jor.22351"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1015350108"},{"key":"r16","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199903000-00007"},{"key":"r17","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198466040-00006"},{"key":"r18","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2012.02.632"},{"key":"r19","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-2194-2"},{"key":"r20","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1583-2"}],"container-title":["The Bone &amp; Joint Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.95B8.31832","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/0301-620X.95B8.31832","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.95B8.31832","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T19:18:01Z","timestamp":1634584681000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/10.1302\/0301-620X.95B8.31832"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8]]},"references-count":20,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2013,8]]}},"alternative-id":["10.1302\/0301-620X.95B8.31832"],"URL":"https:\/\/doi.org\/10.1302\/0301-620x.95b8.31832","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.718195932.793487827","asserted-by":"object"}]},"ISSN":["2049-4394","2049-4408"],"issn-type":[{"value":"2049-4394","type":"print"},{"value":"2049-4408","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,8]]},"assertion":[{"value":"2013-02-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-04-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-08-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}