The management of pathologic fractures

This article outlines the principles of pathologic fracture management and highlights the clinical features that predict impending fracture so that the nonsurgeon can recognize how to integrate orthopedic management into the overall treatment plan for patients with metastatic disease to bone.With the possible exception of carcinoma of the breast, there is little evidence that any treatment increases survival of patients with metastatic carcinoma. However, advances in chemotherapy, radiation therapy, and surgery have undoubtedly increased the quality of life in these patients and has kept them active for longer periods of time. Judicious surgical and physiatric management is needed to optimize care.