[General principles and technics of osteosynthesis in pathological fractures]

Skeletal metastasis and pathologic fractures are signs of progressing neoplastic disease, but they are not life threatening events. Stabilization is necessary to diminish pain and to maintain the quality of life remaining. Principles of surgical stabilization include rigidity for long term functional use, non dependence on bone healing and salvage of as much bone as possible to maintain muscle attachment for limb function. This is achieved by integration of bone, Polymethylmethacrylate and implant into a solid unit. In the treatment of pathologic fractures not caused by malignancy biologic factors like bone transplantation play the predominant role. In case of infection stability and vascularity of the bone is of utmost importance. Vascularity is achieved by pediculated grafts or free tissue transfer.