{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:23:23Z","timestamp":1782401003731,"version":"3.54.5"},"reference-count":22,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Orthopedic and Traumatology School of Universit\u00e0 Cattolica del Sacro Cuore, Roma"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Post-radiation fractures are a significant complication of cancer treatment, often being challenging to manage and impacting patients\u2019 quality of life. This study systematically reviews the literature on fractures in irradiated bones, focusing on risk factors, treatment modalities, and prevention strategies. Factors increasing fracture risk include exposure to high doses of radiation of at least 50 Gy, female gender, menopausal age, and periosteal stripping. Additionally further risk factors are the size of the original tumor and osteoporosis. Methods: A search of PubMed yielded 541 articles, with 4 were ultimately included in the review. These retrospective studies focused on patients undergoing Combined Limb-Sparing Surgery and Radiation Therapy for soft tissue sarcoma. Results: Results show post-radiation fractures affect approximately 4% of patients, with the femur being the most frequently affected site. Intramedullary nailing emerges as the gold standard treatment, with prosthetic replacement or megaprostheses used in the metaepiphyseal region and as salvage procedures. Non-union and infection remain formidable complications. Conclusions: This study highlights the importance of prophylactic nailing in fracture prevention and the efficacy of free vascularized fibular flaps to achieve bone union during revision surgeries. Limited case availability and patient follow-up hinder comprehensive studies, impacting treatment outcomes.<\/jats:p>","DOI":"10.3390\/jcm13113126","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T09:33:31Z","timestamp":1716802411000},"page":"3126","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Recent Advances in the Surgical Management of Radiation-Induced Fractures following Soft Tissue Sarcomas"],"prefix":"10.3390","volume":"13","author":[{"given":"Matteo","family":"Salvini","sequence":"first","affiliation":[{"name":"Orthopedics & Traumatology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, 00168 Roma, Italy"},{"name":"Orthopedics and Traumatology, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"El Motassime","sequence":"additional","affiliation":[{"name":"Orthopedics & Traumatology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, 00168 Roma, Italy"},{"name":"Orthopedics and Traumatology, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cavola","sequence":"additional","affiliation":[{"name":"Orthopedics & Traumatology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, 00168 Roma, Italy"},{"name":"Orthopedics and Traumatology, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Ruberto","sequence":"additional","affiliation":[{"name":"Orthopedics & Traumatology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, 00168 Roma, Italy"},{"name":"Orthopedics and Traumatology, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Ziranu","sequence":"additional","affiliation":[{"name":"Orthopedics & Traumatology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, 00168 Roma, Italy"},{"name":"Orthopedics and Traumatology, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Roma, Italy"},{"name":"Orthopedics and Traumatology, Ospedale Isola Tiberina\u2014Gemelli Isola, 00186 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Maccauro","sequence":"additional","affiliation":[{"name":"Orthopedics & Traumatology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, 00168 Roma, Italy"},{"name":"Orthopedics and Traumatology, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s11912-016-0523-z","article-title":"Advances in Radiation Therapy for Primary and Metastatic Adult Soft Tissue Sarcomas","volume":"18","author":"Blumenfeld","year":"2016","journal-title":"Curr. 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