Published online Aug 26, 2021. doi: 10.12998/wjcc.v9.i24.7053
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
Processing time: 123 Days and 13.5 Hours
A method regarding the appropriate assessment of fracture risk in long bone lesions affected by benign tumor is lacking.
We performed this study to determine an appropriate approach to assess the fracture risk in children with benign bone lesions of long bones.
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.
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.
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.
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.
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.