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Orthotics > Osteosarcoma/Ewings & Limb Saving Vs. Amputation > Flashcards

Osteosarcoma/Ewings & Limb Saving Vs. Amputation Flashcards

1
Q

What gender is more common for bone cancer

A

M>F

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2
Q

Most common sites for bone cancer

A

Distal femur
Prox Tibia
Prox Humerus

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3
Q

What is a characteristic on an x-ray of Osteosarcoma

A

Sunburst type, cloud-like, fluffy appearance

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4
Q

Characteristics on an x-ray of Ewings Sarcoma

A

Onion skin appearance

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5
Q

Treatments for Bone cancer

A

chemo, radiation and surgery

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6
Q

Treatment for Bone cancer

A

Effective chemo and radiation and improved radiographic and surgical techniques have:
increased survival and number of long term survivors

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7
Q

What did increased long-term survivors lead to the development of?

A

new limb sparing techniques to avoid amputations.

Limb salvage provides improved function and QOL over amputation

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8
Q

What percentage of bone tumor patients receive an amputation?

A

5-15%

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9
Q

When may an amputation be required after limb-saving surgery (LSS)?

A

When Limb Saving Surgery (LSS) produces an inadequate margin, a functional outcome that is worse than amputation w/ prosthesis, when it is not able to restore active function, when no adequate muscle remains, or when LSS is not able to obtain soft tissue coverage

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10
Q

Patients receiving an endoprosthesis will most likely have what kind of deficit?

A

ROM restrictions

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11
Q

Which age group has more cases of cancer: Children (0-14) or Young Adults (15-19)

A

Children = 8,700 cases

Young Adults = 3,700

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12
Q

What type of bone tumor make up 6% of all cancers diagnosed under the age of 20?

A

bone cancer

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13
Q

What are the 2 types the predominant types of bone cancer?

A
  1. Osteosarcoma

2. Ewings’ Sarcoma

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14
Q

Where is the most common area for osteocsarcoma/Ewings’ sarcoma to occur?

A

LE and Pelvis

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15
Q

In adult MALES, what are the top 3 types of cancer diagnosed?

A
  1. Prostate - 33%
  2. Lung & Bronchus - 13%
  3. Colon & Rectum - 10%
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16
Q

In adult FEMALES, what are the top 3 types of cancer diagnosed?

A
  1. Breast - 32%
  2. Lung & Bronchus - 12%
  3. Colon & Rectum - 11%
17
Q

What are the top 4 causes of death in children under 20?

A
  1. Accidents
  2. Homicides
  3. Cancer
  4. Suicides
18
Q

What are the top 2 causes of death in adults age 40-59?

A
  1. Cancer

2. Heart Disease

19
Q

Malignant bone tumors make up ___% of all cancers diagnosed under the age of 20 (which represents approx 650-700 new diagnoses per year)

A

6%

20
Q

In children, osteosarcoma makes up __% of bone tumors and Ewings’ Sarcoma makes up __%.

A

Osteosarcoma = 60%

Ewings’ Sarcoma = 34%

21
Q

Which cancer is a primary malignancy of the bone and is derived from primitive bone forming, mesenchyme?

A

Osteosarcoma

22
Q

Which cancer is derived from parasympathetic neural crest cells, aka “small round blue cell”?

A

Ewings’ Sarcoma

23
Q

What do the studies show about function in limb salvage?

A
  • tendency toward improved function but it’s not overwhelming
24
Q

What do studies show about quality of life after a limb salvage?

A
  • limited studies of children following bone tumors

- limb salvage not proven to be substantially superior

25
Q

What are the four questions when thinking about Limb Salvage vs. Amputation?

A
  1. Will survival be the same?
  2. Will the immediate and late morbidities be the same?
  3. Will limb salvage improve function?
  4. Will limb salvage have psychosocial (QOL) benefits?
26
Q

Children Special Issues: Physical Immaturity

A
  • growth potential

- impacts the type of reconstruction: use expanding prosthesis w/multiple lengthening procedures and amputation

27
Q

Children Special Issues: Psychological Immaturity & Multiple surgeries

A
  • preadolescence vs adolescence: wide range of different impacts depending on age and maturity
  • direct impact on function & QOL
  • body image
  • social interactions
  • long life spans
28
Q

Early complications with limb salvage

A

ST necrosis; deep infection; artery/vein/nerve damage; venous thrombosis; delay in chemotherapy

29
Q

Late complications with limb salvage

A

nonunion; pathological fracture; aseptic loosening; leg length discrepancy; implant breakage

30
Q

Early complications with amputations

A

Inadequate wound coverage and healing; infection; delay in chemotherapy

31
Q

Late complications with amputations

A

Stump-prosthesis problems; stump pain; phantom limb pain; bone overgrowth

Orthotics (11 decks)

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