Metastasis size in pathologic femoral fractures

Radiographic assessment was made of metastases in 69 consecutive patients with pathologic femoral fractures. The following variables were considered: width of metastasis, ratio between width of metastasis and bone, axial length of cortical destruction, and proportion of cortical bone destroyed of the circumference. Differences in size of the metastases were not related to location in the femur or histologic type. In 62 of 69 fractures the ratio between width of the metastasis and bone was greater than or equal to 0.60, axial cortical destruction in the neck was greater than or equal to 13 mm and in other parts of the femur greater than or equal to 30 mm, and cortical destruction of the circumference greater than or equal to 50 percent. Prophylactic internal fixation need not be considered for femur metastatic lesions that do not reach these limits.