(P 256) CHARACTERIZING ORTHOPAEDIC ONCOLOGIC POLYTRAUMAS: A COMPARISON OF PATIENTS UNDERGOING OPERATIVE FIXATION OF MULTIPLE LESIONS WITH THOSE WITH SOLITARY LESIONS

Objective: Orthopaedic oncology polytraumas are understudied but increasingly prevalent due to growing long-term survival of metastatic cancer patients. Existing studies offer contradictory results regarding the management of multiple fractures with staged vs. simultaneous operative fixation. This study aims to evaluate the incidence of patients presenting with multiple lesions and compare patient/disease characteristics, treatment algorithms, and outcomes to patients with solitary lesions.

Methods: As part of a multi-center study, a retrospective review of patients in our institution’s orthopedic oncology practice is being conducted. Patients aged 18-89 who presented with one or multiple pathologic or impending long-bone fractures secondary to metastatic carcinoma, plasmacytoma/multiple myeloma, or lymphoma between 1/1/1998 and 10/31/2020 are included. Data on demographics, preoperative characteristics, fracture details, and postoperative status are being collected from patients’ medical charts. Data will be summarized with descriptive statistics and chi-squared tests.

Results: Initial data from 50 patients has been collected, including 9 patients with multiple fractures. The most common primary tumors were lung (n=11), breast (n=11), and renal cell carcinoma (n=11), with femur fractures (n=41) predominating. The mortality rate was 9/9 among the multiple lesion patients and 29/41 among the solitary lesion patients (RR = 1.41, 95% CI [1.16, 1.72]). Average survival post-operation was higher for polyostotic patients (85.11 weeks vs. 41.79 weeks).

Conclusion: The results from this multi-center study involving 13 U.S. sites will help predict which patient populations are more susceptible to oncologic polytraumas and what treatment algorithms are associated with reduced mortality and risk of complications.