Pathologic Fracture Discussion

A pathologic fracture occurs through a weakened area of bone, typically from a bone tumor. Bone tumors may be benign or malignant, and differentiation may be difficult. Statistically, most bone tumors are benign. If the tumor does prove to be malignant, major resection or amputation with or without adjuvant therapy may be required. Malignant bone tumors may spread uncontrollably and result in death. Benign tumors may be locally aggressive and can recur even after surgical removal, at times requiring amputation for local control. The most exact diagnostic technique is biopsy to obtain tissue for pathologic examination. Any bone tumor may weaken the bone and result in pathologic fracture. Unfortunately, because of the healing process, needle biopsy of a pathologic fracture may be difficult to distinguish from osteogenic sarcoma, and MRI of a recent fracture may not be able to differentiate between fracture hematoma and extraosseous bone involvement. Treatment options include observation with additional xrays or MRI scans taken at regular intervals to monitor any progressive change, further bone scans or biopsy. Unless there is strong evidence of an aggressive malignant tumor or uncontrollable mechanical instability, pathologic fractures are allowed to heal before proceeding with definitive excision.

Discussion Home Page