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Fracture risk assessment in children with benign bone lesions of long bones

BACKGROUND: Fracture risk assessment in children with benign bone lesions of long bones remains poorly investigated. AIM: To investigate the risk factors for pathological fracture in children with benign bone lesions and to propose a modified scoring system for quantitative analysis of the pathologi...

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Autores principales: Li, Hai-Bing, Ye, Wen-Song, Shu, Qiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8409192/
https://www.ncbi.nlm.nih.gov/pubmed/34540960
http://dx.doi.org/10.12998/wjcc.v9.i24.7053
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author Li, Hai-Bing
Ye, Wen-Song
Shu, Qiang
author_facet Li, Hai-Bing
Ye, Wen-Song
Shu, Qiang
author_sort Li, Hai-Bing
collection PubMed
description BACKGROUND: Fracture risk assessment in children with benign bone lesions of long bones remains poorly investigated. AIM: To investigate the risk factors for pathological fracture in children with benign bone lesions and to propose a modified scoring system for quantitative analysis of the pathologic fracture risk. METHODS: We retrospectively reviewed 96 pediatric patients with benign bone lesions. We compared radiographic and clinical features between 40 patients who had fractures through a benign bone lesion and 56 who had no fracture. Information including histological diagnosis, anatomical site, radiographic appearance, severity of pain, and lesion size was recorded for the patients. A modified scoring system was proposed to predict the risk of fracture. RESULTS: The univariate comparisons showed a significant difference between the fracture and non-fracture groups in terms of lesion type, pain, lesion-to-bone width, and axial cortical involvement of the patients (P < 0.05). Lesion type, pain, lesion-to-bone width, and axial cortical involvement were independently correlated with an increased risk of fracture. The mean score of the fracture group was 7.89, whereas the mean score of the non-fracture group was 6.01. The optimum cut-off value of the score to predict pathological fracture was 7. The scoring system had a sensitivity of 70% and a specificity of 80% for detecting patients with fractures. The Youden index was 0.5, which was the maximum value. The area under the receiver operator characteristic was 0.814. CONCLUSION: Lesion type, pain, lesion-to-bone width, and axial cortical involvement are risk factors for pathological fracture. The modified scoring system can provide evidence for clinical decision-making in children with benign bone lesions. A bone lesion with a total score > 7 indicates a high risk of a pathologic fracture and is an indication for prophylactic internal fixation.
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spelling pubmed-84091922021-09-16 Fracture risk assessment in children with benign bone lesions of long bones Li, Hai-Bing Ye, Wen-Song Shu, Qiang World J Clin Cases Retrospective Study BACKGROUND: Fracture risk assessment in children with benign bone lesions of long bones remains poorly investigated. AIM: To investigate the risk factors for pathological fracture in children with benign bone lesions and to propose a modified scoring system for quantitative analysis of the pathologic fracture risk. METHODS: We retrospectively reviewed 96 pediatric patients with benign bone lesions. We compared radiographic and clinical features between 40 patients who had fractures through a benign bone lesion and 56 who had no fracture. Information including histological diagnosis, anatomical site, radiographic appearance, severity of pain, and lesion size was recorded for the patients. A modified scoring system was proposed to predict the risk of fracture. RESULTS: The univariate comparisons showed a significant difference between the fracture and non-fracture groups in terms of lesion type, pain, lesion-to-bone width, and axial cortical involvement of the patients (P < 0.05). Lesion type, pain, lesion-to-bone width, and axial cortical involvement were independently correlated with an increased risk of fracture. The mean score of the fracture group was 7.89, whereas the mean score of the non-fracture group was 6.01. The optimum cut-off value of the score to predict pathological fracture was 7. The scoring system had a sensitivity of 70% and a specificity of 80% for detecting patients with fractures. The Youden index was 0.5, which was the maximum value. The area under the receiver operator characteristic was 0.814. CONCLUSION: Lesion type, pain, lesion-to-bone width, and axial cortical involvement are risk factors for pathological fracture. The modified scoring system can provide evidence for clinical decision-making in children with benign bone lesions. A bone lesion with a total score > 7 indicates a high risk of a pathologic fracture and is an indication for prophylactic internal fixation. Baishideng Publishing Group Inc 2021-08-26 2021-08-26 /pmc/articles/PMC8409192/ /pubmed/34540960 http://dx.doi.org/10.12998/wjcc.v9.i24.7053 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Study
Li, Hai-Bing
Ye, Wen-Song
Shu, Qiang
Fracture risk assessment in children with benign bone lesions of long bones
title Fracture risk assessment in children with benign bone lesions of long bones
title_full Fracture risk assessment in children with benign bone lesions of long bones
title_fullStr Fracture risk assessment in children with benign bone lesions of long bones
title_full_unstemmed Fracture risk assessment in children with benign bone lesions of long bones
title_short Fracture risk assessment in children with benign bone lesions of long bones
title_sort fracture risk assessment in children with benign bone lesions of long bones
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8409192/
https://www.ncbi.nlm.nih.gov/pubmed/34540960
http://dx.doi.org/10.12998/wjcc.v9.i24.7053
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