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[(Impending) pathological fracture].

P M Sutter1, P Regazzoni

  • 1Abteilung für Traumatologie, Allgemeinchirurgische Klinik, Departement Chirurgie, Universität Basel, Kantonsspital, CH-4031 Basel.

Swiss Surgery = Schweizer Chirurgie = Chirurgie Suisse = Chirurgia Svizzera
|May 17, 2002
PubMed
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Pathological fractures are increasing due to longer cancer survival. Surgical intervention is crucial for impending fractures, with Mirels score aiding risk assessment.

Area of Science:

  • Oncology
  • Orthopedic Surgery
  • Radiology

Background:

  • Increasing cancer survival leads to more pathological fractures.
  • Bone metastases are common, particularly from breast and lung cancers.
  • Femoral fractures are most frequent despite spinal metastases.

Purpose of the Study:

  • To discuss the diagnosis and management of pathological fractures.
  • To highlight the importance of operative intervention for impending fractures.
  • To review current treatment strategies and risk assessment.

Main Methods:

  • Review of pathological fracture incidence and causes.
  • Discussion of diagnostic criteria for impending fractures.
  • Analysis of Mirels score for fracture risk assessment.

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  • Overview of surgical techniques and adjuvant therapies.

    • Main Results:

    • Pathological fractures are a growing concern in cancer patients.
    • Mirels score effectively estimates fracture risk.
    • Prosthetic replacement and intramedullary nails are standard surgical treatments.
    • Postoperative radiation and aggressive tumor removal improve outcomes.

    Conclusions:

    • Prompt surgical intervention is vital for pathological and impending fractures.
    • Risk stratification using Mirels score guides treatment decisions.
    • Multidisciplinary management optimizes quality of life and prognosis.