Pathologic Fracture Management
Management of pathological fractures requires a tailored approach based on the underlying tumour type, location, prognosis, and functional demands.
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Initial assessment involves distinguishing between benign, metastatic, and primary malignant causes. Imaging (X-ray, MRI, CT) and histopathology (biopsy) are essential.In metastatic disease, stabilisation aims to restore function and relieve pain. Intramedullary nailing, plate fixation, or modular prostheses are selected based on fracture location and bone stock.For primary bone malignancies, management typically involves en bloc resection followed by reconstruction.Prophylactic fixation may be considered in lesions with high risk of fracture (e.g., Mirels score ≥ 9).Decision-making should include oncologic input, especially when adjuvant therapy (e.g., radiotherapy or chemotherapy) is planned.
