Abstract:

BACKGROUND: There are many reports regarding pathological fractures, but follow-up of large samples are few and the diagnosis methods vary, leading to lacks of uniform rule.
OBJECTIVE: To discuss the diagnosis and treatment of tumorous long bone pathological fractures.
METHODS: From August 2002 to August 2009, 143 consecutive hospitalized pathological patients were enrolled, including 100 long bone fractures involving 96 tumorous fractures, 4 multiple site, 32 metastases, 24 primary malignant tumors, 29 benign tumors, and 15 giant cell tumors. The diagnosis and treatments of pathological fractures were retrospectively analyzed.
RESULTS AND CONCLUSION: All the patients were followed up for 6 to 56 months with an average of 26.5 months. Violence-induced fractures were classified into four groups: 18 cases of spontaneous, 29 cases of functional activities, 46 cases of minor injuries, and 7 cases of severe injuries. A total of 76 patients complained discomforts such like pain at fracture cites. In 13 cases with metastases, resection of mass was followed by construction prosthesis with no local recurrences; 11 patients with metastases were treated with intramedullary nail, with 2 cases recurrences, and 2 cases died. Operation was not accepted in 3 cases. Of patients with osteosarcoma accepting limb sparing operation, 4 cases accepted amputation, all of which had no relapses but with lung metastases in 3 patients; 3 cases with malignant fibrous hisfiocytoma were resected and followed by construction prosthesis; 2 cases accepted amputation, one of which was misdiagnosed and died at last follow-up. Pathological fractures should be highly suspected in minor injury patients. Treatment of pathological fractures should consider multiple factors such as specific tumor character and fracture locations. It is a better way to choose arthroplasty for fractures adjacent to joints.