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Successful Management of Radiation-Associated Insufficiency Fracture of the Tibial Plateau with Low-Intensity Pulsed Ultrasound

Patient: Female, 52-year-old Final Diagnosis: Fracture Symptoms: Knee pain Medication:— Clinical Procedure: — Specialty: Oncology OBJECTIVE: Unusual or unexpected effect of treatment BACKGROUND: Clinical management of radiation-associated pathological fracture is challenging because of a high nonuni...

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Autores principales: Matsunobu, Tomoya, Maekawa, Akira, Nomoto, Satoshi, Iwamoto, Yukihide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8772390/
https://www.ncbi.nlm.nih.gov/pubmed/35031593
http://dx.doi.org/10.12659/AJCR.934372
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author Matsunobu, Tomoya
Maekawa, Akira
Nomoto, Satoshi
Iwamoto, Yukihide
author_facet Matsunobu, Tomoya
Maekawa, Akira
Nomoto, Satoshi
Iwamoto, Yukihide
author_sort Matsunobu, Tomoya
collection PubMed
description Patient: Female, 52-year-old Final Diagnosis: Fracture Symptoms: Knee pain Medication:— Clinical Procedure: — Specialty: Oncology OBJECTIVE: Unusual or unexpected effect of treatment BACKGROUND: Clinical management of radiation-associated pathological fracture is challenging because of a high nonunion rate and potential for morbidity. We report a case of radiation-associated insufficiency fracture of the tibial plateau after surgery, perioperative chemotherapy, and adjuvant radiation therapy for synovial sarcoma of the proximal calf that was successfully treated with low-intensity pulsed ultrasound (LIPUS). CASE REPORT: A healthy 52-year-old Japanese woman presented with a slowly growing, painful soft tissue mass over her proximal calf. Histological examination of core needle biopsy specimens led to a pathological diagnosis of synovial sarcoma. After perioperative ifosfamide and doxorubicin chemotherapy and surgical resection, adjuvant radiation therapy was administered, with a total of 60 Gy in 30 fractions. At 5 months after surgery and 2 months after the completion of radiation therapy, she developed an insufficiency pathological fracture of the proximal tibia without any apparent trauma. The patient was treated with LIPUS for 1 year. There was no collapse or deformity of the knee joint. The patient remained free of symptoms and had no recurrences for 2 years after surgery. CONCLUSIONS: This is the first report of radiation-associated pathological fracture that was successfully treated with LIPUS. LIPUS could be a safe and effective treatment option in the management of radiation-associated pathological fractures.
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spelling pubmed-87723902022-02-03 Successful Management of Radiation-Associated Insufficiency Fracture of the Tibial Plateau with Low-Intensity Pulsed Ultrasound Matsunobu, Tomoya Maekawa, Akira Nomoto, Satoshi Iwamoto, Yukihide Am J Case Rep Articles Patient: Female, 52-year-old Final Diagnosis: Fracture Symptoms: Knee pain Medication:— Clinical Procedure: — Specialty: Oncology OBJECTIVE: Unusual or unexpected effect of treatment BACKGROUND: Clinical management of radiation-associated pathological fracture is challenging because of a high nonunion rate and potential for morbidity. We report a case of radiation-associated insufficiency fracture of the tibial plateau after surgery, perioperative chemotherapy, and adjuvant radiation therapy for synovial sarcoma of the proximal calf that was successfully treated with low-intensity pulsed ultrasound (LIPUS). CASE REPORT: A healthy 52-year-old Japanese woman presented with a slowly growing, painful soft tissue mass over her proximal calf. Histological examination of core needle biopsy specimens led to a pathological diagnosis of synovial sarcoma. After perioperative ifosfamide and doxorubicin chemotherapy and surgical resection, adjuvant radiation therapy was administered, with a total of 60 Gy in 30 fractions. At 5 months after surgery and 2 months after the completion of radiation therapy, she developed an insufficiency pathological fracture of the proximal tibia without any apparent trauma. The patient was treated with LIPUS for 1 year. There was no collapse or deformity of the knee joint. The patient remained free of symptoms and had no recurrences for 2 years after surgery. CONCLUSIONS: This is the first report of radiation-associated pathological fracture that was successfully treated with LIPUS. LIPUS could be a safe and effective treatment option in the management of radiation-associated pathological fractures. International Scientific Literature, Inc. 2022-01-15 /pmc/articles/PMC8772390/ /pubmed/35031593 http://dx.doi.org/10.12659/AJCR.934372 Text en © Am J Case Rep, 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Matsunobu, Tomoya
Maekawa, Akira
Nomoto, Satoshi
Iwamoto, Yukihide
Successful Management of Radiation-Associated Insufficiency Fracture of the Tibial Plateau with Low-Intensity Pulsed Ultrasound
title Successful Management of Radiation-Associated Insufficiency Fracture of the Tibial Plateau with Low-Intensity Pulsed Ultrasound
title_full Successful Management of Radiation-Associated Insufficiency Fracture of the Tibial Plateau with Low-Intensity Pulsed Ultrasound
title_fullStr Successful Management of Radiation-Associated Insufficiency Fracture of the Tibial Plateau with Low-Intensity Pulsed Ultrasound
title_full_unstemmed Successful Management of Radiation-Associated Insufficiency Fracture of the Tibial Plateau with Low-Intensity Pulsed Ultrasound
title_short Successful Management of Radiation-Associated Insufficiency Fracture of the Tibial Plateau with Low-Intensity Pulsed Ultrasound
title_sort successful management of radiation-associated insufficiency fracture of the tibial plateau with low-intensity pulsed ultrasound
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8772390/
https://www.ncbi.nlm.nih.gov/pubmed/35031593
http://dx.doi.org/10.12659/AJCR.934372
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