Orthopedic tumors are classified according to their origin, biological behavior, and localization:

1. **By origin:**

- **Primary tumors:** Tumors that originate directly in bone or soft tissue.

- **Secondary tumors (metastases):** Tumors that occur as secondary growths from other malignant diseases, e.g., in breast or lung cancer.

2. **By biological behavior:**

- **Benign:** Tumors that grow slowly and generally do not form metastases, e.g., osteochondroma or lipoma.

- **Malignant:** Tumors that grow invasively and can form metastases, e.g., osteosarcoma or Ewing's sarcoma.

3. **By localization:**

- **Bone tumors:** Tumors that occur in the skeletal system, e.g., osteoid osteoma.

- **Soft tissue tumors:** Tumors in muscles, fatty tissue, or ligaments, e.g., liposarcoma.

The exact causes of tumors in orthopedics are often unknown. Some known risk factors include:

• Genetic predisposition:
  • Hereditary syndromes such as Li-Fraumeni syndrome or hereditary retinoblastoma can increase the risk.
• Environmental factors:
  • Radiation exposure or chemical carcinogens.
• Chronic diseases:
  • Pre-existing bone diseases such as Paget's disease.
• Trauma:
  • Although rare, injuries can act as a trigger for the discovery of a tumor.

The symptoms vary depending on the type, size, and location of the tumor, but typically include:

• Pain:
  • Persistent, often load-independent pain that may worsen at night.
• Swelling:
  • Visible or palpable swelling in the affected area.
• Movement restrictions:
  • Impaired mobility or function of the affected joint or limb.
• Fractures:
  • Pathological bone fractures that occur without adequate trauma.
• Systemic symptoms:
  • Fever, weight loss, or fatigue, especially in malignant tumors.

The diagnosis of tumors requires a combination of medical history, clinical examination, and imaging techniques:

• Medical History:
  • Collection of symptoms, duration, and possible risk factors.
• Physical Examination:
  • Examination for swelling, tenderness, and functional limitations.
• Imaging:
  • X-ray: Initial depiction of bony changes or tumor patterns.
  • MRI: Detailed analysis of soft tissues and tumor extent.
  • CT: Precise assessment of bone structures and tumor boundaries.
  • Bone Scintigraphy: Detection of metastases or multifocal tumors.
• Biopsy:
  • Histological examination to differentiate between benign and malignant.
• Laboratory Tests:
  • Tumor markers in the blood to support diagnostics in certain tumors.

Conservative Therapy

For benign tumors or small tumors, conservative treatment may be sufficient:

• Observation:
  • Regular check-ups for slow-growing tumors.
• Pain management:
  • Medications like NSAIDs for pain relief.
• Physiotherapy:
  • Promoting mobility and stability after treatment.

Surgical Therapy

Surgical removal is necessary for most tumors, especially malignant ones:

• Tumor resection:
  • Surgical removal of the tumor with sufficient safety margin.
• Reconstructive measures:
  • Use of prostheses, bone grafts, or implants to restore function.
• Amputation:
  • Rarely necessary when the tumor cannot be completely removed.
• Minimally invasive procedures:
  • For example, radiofrequency ablation for small tumors.

Systemic Therapy

For malignant tumors, systemic treatment may be required:

• Chemotherapy: For the treatment of sarcomas or metastases.
• Radiation therapy: Supplementary for tumors that cannot be completely removed.
• Immunotherapy: In special cases to strengthen the body's defenses.

The following measures are suitable for the prevention and early detection of tumors:

1. Regular check-ups: Especially with genetic predisposition or existing risk factors.
2. Healthy lifestyle: Balanced diet, avoidance of smoking and excessive radiation exposure.
3. Early detection: Early medical clarification in case of persistent pain or swelling.
4. Protection against injuries: Avoidance of overstrain and protection during sports activities.
5. Education: Raising awareness of symptoms and risk factors.