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Predict Risk of Femur Fracture Following Treatment of Soft Tissue Sarcoma

Purpose: To predict the risk of a pathologic fracture of the femur following combined modality therapy of a soft tissue sarcoma of the thigh.

Description

Gortzak et al developed a nomogram for predicting the risk of pathologic fracture of the femur following combined modality therapy for a soft tissue sarcoma of the thigh. The authors are from the University of Toronto, Sourasky Medical Center in Tel Aviv, and teaching hospitals in Toronto, Canada.


Paramters:

(1) gender

(2) age in years

(3) compartment

(4) tumor diameter in cm

(5) radiation dose

(6) periosteal stripping in cm

 

Age in Years

Points

< 20 years

0

20 to 90 years

(1.4286 * (age)) - 28.572

> 90 years

100

 

 

Tumor Size

Points

0 to 28 cm

2.939 * (diameter in cm)

> 28 cm

82

 

 

Parameter

Finding

Points

gender

male

0

 

female

34.6

compartment

posterior

0

 

anterior

48.3

 

adductor

25.5

 

other (abductor, groin)

4

radiation dose

low (50 Gy)

0

 

high (>= 60 Gy)

12.6

periosteal stripping

< 10 cm

0

 

10 to 20 cm

14.6

 

> 20 cm

9.4

 

total score =

= SUM(points for all 6 paramters)

 

Interpretation:

• minimum score: 0

• maximum score: 290+

• The higher the score the greater the risk of pathologic fracture.

 

Total Score

Probability of Pathologic Fracture

< 128

< 5%

128 to 161

(0.008863 * ((points)^2)) - (1.898 * (points)) + 102.4

161 to 199

(1.316 * (points)) - 186.8

199 to 232

(-0.008863 * ((points)^2)) + (4.484 * (points)) - 467.9

> 232

> 95%

 


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Specialty

Objective

ICD-10