![]() ![]() He returned for regular follow-up and his pathologic humeral fracture healed uneventfully. He followed up with an oncologist for further evaluation and treatment. Fracture reduction and fixation was planned and performed using an expandable retrograde intramedullary humeral nail. Additional tests were performed to further evaluate the pathologic fracture and metastatic lytic lesions. Helfet, MD at the Orthopedic Trauma Service at Hospital for Special Surgery for definitive fracture management. His right arm was placed in a fracture splint and he was referred to David L. Radiographs at the local hospital revealed a right-sided pathologic mid-shaft humeral fracture and evidence of lytic lesions on the humeral head. If required, the reader can try to do the assessment.A 70-year-old male slipped and fell while skiing, landing on his outstretched right arm. According to other research and our experience, we added if 'no X-rays are available' scenario to the assessment method. We have created an online table that allows clinicians to use as a reference for assessing the risk of pathological fractures. Similarly, if the total score is less than nine points, regular outpatient tracking must continue, and the above items should be considered. Take more vitamin D (sea fish, eggs, milk, and liver). More exposure to the sun (half an hour per day, even only palm exposure is fine).Ĥ. Use crutches, stents, and other aids to assist with daily activities, depending on the condition.ģ. However, if the patient is in poor health and unable to take surgery, considerable care must be taken to avoid falls, followed by continuous outpatient follow-up. ![]() Generally, in clinical situations, when the total score is equal to or greater than nine points, if the patient's physical condition is capable, surgical fixation of the broken bones should be prompt to avoid pathological fractures. Coupled with the fact the residual tumors can remain at the surgical region, the post-surgical recovery at the fracture sites is poor.Ī total score equals nine points, a 30 to 80% chance of pathological fractures will occur.Ī total score greater than nine points, greater than 80% chance of pathological fractures will occur. Hence, the overall risk of surgery and anesthesia is higher than usual.įourth: Pathological fracture brings more damage to the bone structure, and post-surgical radiation therapies are mostly needed. Third: The patients with pathological fractures have poor health. ![]() Because larger bone defects exist, doctors need to reconstruct bone defects with bone cement, allograft bones, or bone substitutes during surgery. Therefore, pathological fractures usually have large bone defects. Second: Tumors can damage the bone structure. In terms of surgery, pathological fractures are often more difficult than normal fractures because:įirst: Surgery for pathological fracture would need to remove the tumor simultaneously the surgery takes a long time. Therefore, in most cases, both require surgery to treat. However, any fracture can cause pain and loss of limb function. Hence, fractures occur in minor injuries, such as twisting. Pathological fractures are caused by tumors or myelitis, etc., which cause damage to bone structure. General fractures are caused by severe trauma, such as car accidents, falls, etc. From the table above, we can understand that pathological fractures are different from general fractures in the cause.
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