Pathologic Fractures of the Femur and Humerus

Abstract

Pathologic fractures are those that occur in bones with abnormal structure, and are commonly associated with metastatic invasion of primary carcinomas such as breast, lung, and renal cell. Preoperative evaluation of patients should include a thorough patient history and physical examination, as well as focused laboratory tests and imaging studies. A multidisciplinary approach is recommended for determining an optimal surgical plan. The goals of treatment of pathologic fractures are focused on pain control, maintaining mobility, and improving the patient’s quality of life. Options for reconstruction should allow for early weight bearing and should be based on the location of the fracture, the quality of surrounding bone, and the histologic diagnosis. Patients with displaced pathologic fractures of the femur who have a life expectancy estimated to be beyond 12 months should be evaluated for endoprosthetic reconstruction to avoid late complications associated with internal fixation.

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