Netsu Toshio, Tsuchiya Masato, Kubo Satoshi, Azuma Ryuichi
Department of Plastic and Reconstructive Surgery, National Defense Medical College, Tokorozawa, JPN.
Cureus. 2025 Apr 24;17(4):e82898. doi: 10.7759/cureus.82898. eCollection 2025 Apr.
Radiotherapy is a common cancer treatment that may cause long-term complications such as bone and neurological disorders. This study presents a pathological clavicular fracture that occurred 50 years after radiotherapy for a sarcoma. A 67-year-old female with a history of radiation therapy following surgery at the age of 10 years developed a clavicular fracture without trauma. Prior to the fracture, the patient experienced progressive brachial plexopathy over the past 15 years. Biopsy revealed no malignancy, which led to the diagnosis of a pathological fracture. This study illustrates the delayed onset of radiation-induced complications, with neurological damage appearing earlier than the fracture. Moreover, it underscores the importance of considering radiation-induced bone fragility in patients with unexplained fractures, particularly individuals with prior radiation exposure. Early detection of neurological damage, such as brachial plexopathy, may offer an opportunity for preventive care. Furthermore, it highlights the necessity of patient education regarding the long-term effects of radiation therapy, including bone fragility and the risk of pathological fractures.
放射治疗是一种常见的癌症治疗方法，可能会导致长期并发症，如骨骼和神经紊乱。本研究报告了一例肉瘤放疗50年后发生的病理性锁骨骨折。一名67岁女性，10岁时接受手术及放疗，此次无外伤却发生了锁骨骨折。骨折前，患者在过去15年中出现了进行性臂丛神经病变。活检未发现恶性肿瘤，从而诊断为病理性骨折。本研究说明了放射诱导并发症的延迟发生，神经损伤比骨折出现得更早。此外，它强调了在不明原因骨折患者中，尤其是有放疗史的个体，考虑放射诱导骨脆性的重要性。早期发现神经损伤，如臂丛神经病变，可能为预防性护理提供机会。此外，它突出了对患者进行放疗长期影响教育的必要性，包括骨脆性和病理性骨折风险。
