Treatment of pathologic fracture following postoperative radiation therapy: clinical study.

BACKGROUND: Pathologic fractures are caused by diseases that lead to weakness of the bone structure. This process sometimes occurs owing to bony change after radiation therapy. Treatment of pathologic fractures may be difficult because of previous radiation therapy. METHODS: In this study, we analyzed clinical and radiographic data and progress of five patients with mandibular pathological fractures who had received postoperative radiation therapy following cancer surgery. RESULT: Patients received an average radiation dose of 59.2 (SD, 7.2) Gy. Four of five patients exhibited bone union regardless of whether open reduction and internal fixation (OR/IF) was performed. Patients have the potential to heal after postoperative radiation therapy. Treatment of a pathologic fracture following postoperative radiation therapy, such as traditional treatment for other types of fractures, may be performed using OR/IF or CR. OR/IF may be selected in cases of significant bone deviation, small remaining bone volume, or occlusive change. CONCLUSION: Patients have the potential to heal after postoperative radiation therapy.