What Researchers Did
Researchers reviewed the charts of 37 patients with late-stage osteoradionecrosis of the mandible and pathologic fractures, examining outcomes of reconstruction with osteocutaneous free tissue transfer, often combined with hyperbaric oxygen therapy.
What They Found
The average time from completion of radiation therapy to ORN-induced pathologic fracture was 3.2 years, with 95% of patients returning to prefracture dietary intake after treatment. The overall complication rate was 24%, and while no total flap loss occurred, patients who did not receive hyperbaric oxygen therapy experienced 2 skin paddle losses and 4 bony nonunions compared to none in the group that received it.
What This Means for Canadian Patients
Canadian patients experiencing severe osteoradionecrosis of the jaw with fractures may benefit from complex surgical reconstruction involving free tissue transfer. The findings suggest that hyperbaric oxygen therapy, when integrated into the treatment protocol, could potentially reduce complications like bony nonunions.
Canadian Relevance
This study has no direct Canadian connection as it was conducted at a tertiary care center outside of Canada.
Study Limitations
As a retrospective case series, this study's findings may be limited by its observational nature, lack of a control group, and potential for selection bias.