[Pathological fractures of the extremities]

The diagnostics and treatment of pathological fractures of the extremities differ from the approach for conventional fractures. Metastases from breast, bronchial, renal cell and prostate cancer are the predominant cause. Typically, patients present at over 50 years old present after an inadequate trauma. They often report symptoms or swelling in the affected region that already existed before the fracture. An underlying malignant disease is sometimes already known; however, occasionally this is manifested in the form of a fracture. The femur is affected in 74% of cases, followed by the humerus and the tibia. Important indications for the presence of a pathological fracture can even be obtained from conventional radiographs. The diagnostics are supplemented with further modalities depending on the treatment goal. Surgical treatment is the first choice as the fractures do not heal using conservative measures. In this context, a prognosis-stratified approach is recommended.