Li HB, Ye WS, Shu Q. Fracture risk assessment in children with benign bone lesions of long bones. World J Clin Cases 2021; 9(24): 7053-7061 [PMID: 34540960 DOI: 10.12998/wjcc.v9.i24.7053]
Corresponding Author of This Article
Qiang Shu, PhD, Chief Doctor, Department of Pediatric Surgery, The Children’s Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou 310052, Zhejiang Province, China. shuqiang@zju.edu.cn
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 26, 2021; 9(24): 7053-7061 Published online Aug 26, 2021. doi: 10.12998/wjcc.v9.i24.7053
Fracture risk assessment in children with benign bone lesions of long bones
Hai-Bing Li, Wen-Song Ye, Qiang Shu
Hai-Bing Li, Wen-Song Ye, Department of Paediatric Orthopaedics, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou 310052, Zhejiang Province, China
Qiang Shu, Department of Pediatric Surgery, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou 310052, Zhejiang Province, China
Author contributions: Li HB carried out the majority of the study, analyzed data, and prepared the manuscript; Ye WS supervised the study and wrote most of the manuscript; Shu Q provided suggestions for the study and critically reviewed the manuscript; all authors read and approved the final manuscript.
Supported byNatural Science Foundation of Zhejiang Province, No. LY20H060001.
Institutional review board statement: The study was reviewed and approved by the Children's Hospital of Zhejiang University Institutional Review Board, No. 2020-IRB-052.
Informed consent statement: A written consent was obtained from all participants prior to this study.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang Shu, PhD, Chief Doctor, Department of Pediatric Surgery, The Children’s Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou 310052, Zhejiang Province, China. shuqiang@zju.edu.cn
Received: April 22, 2021 Peer-review started: April 22, 2021 First decision: May 24, 2021 Revised: May 29, 2021 Accepted: June 22, 2021 Article in press: June 22, 2021 Published online: August 26, 2021
ARTICLE HIGHLIGHTS
Research background
A method regarding the appropriate assessment of fracture risk in long bone lesions affected by benign tumor is lacking.
Research motivation
We performed this study to determine an appropriate approach to assess the fracture risk in children with benign bone lesions of long bones.
Research objectives
The purpose of this study was to investigate the risk factors of pathological fracture and to propose a modified scoring system for quantitative analysis of the pathologic fracture risks.
Research methods
We retrospectively analyzed the histological diagnosis, anatomical site, radiographic appearance, severity of pain, and lesion size of 40 patients who had fractures through a benign bone lesion and 56 who had no fracture at our institution.
Research results
Through retrospective analysis of 96 patients using our proposed scoring system, we found the cutoff was 7 in consideration of the optimum combination of specificity and sensitivity. The overall accuracy was 76% and fracture probability was 30%. The receiver operator characteristic curve analysis demonstrates that the modified scoring system is good regarding accuracy and has a similar area under the curve with the Mirels scoring system.
Research conclusions
We set score of 7 as borderline. Lesion with a score > 7 is an indication for prophylactic stabilization because of high fracture risk, while lesion with a score < 7 is evaluated as low fracture risk without concern for prophylactic stabilization.
Research perspectives
In follow-up work, a prospective, multicenter, large-scale study will be conducted to validate and improve our proposed scoring system for assessment of the fracture risk in children with benign bone lesions of long bones.
