[The problem of load stability in pathological fractures. Considerations on its indications using typical cases as...

Differentiated management of pathological fractures and multiple bone metastases is shown by means of 7 typical case examples. In the proximal femur, the total replacement of tumor-bearing bone areas by total hip prosthesis seems to provide the best stability. The femur shaft is stabilised without risk by intramedullary nailing, whereas metaphyseal stabilisation is best done by means of the interlocking nail. In the humerus, neutralisation plates are used, but they should be chosen long enough to anchor the implant in zones free fo tumour. The limitations of operability are demonstrated in one case. On the other hand, one case is shown where multiple metastases were treated palliatively by excochleation and filling the defect with bone cement, thus preserving the functional ability of the limb and the independence of the patient.