Concurrent pathologic femoral shaft fracture in bone metastasis and acute myocardial infarction: a case report

An 86-year-old woman with a history of hepatocellular carcinoma was brought to our emergency department after an indoor fall. Her chief complaint was pain in the left thigh and chest. The patient was diagnosed with a pathological femoral shaft fracture, bone metastasis, and acute myocardial infarction. She underwent preoperative embolization and percutaneous coronary intervention, followed by internal fixation on the same day as the injury. The patient was discharged without postoperative myocardial infarction and was able to walk independently using a walker. Femoral diaphyseal fractures and coronary events require urgent intervention, and their coexistence makes it particularly difficult to determine the treatment sequence and timing. In addition, if the fracture is pathological due to bone metastasis, management becomes even more challenging. A multidisciplinary team is essential for the successful management of such complex cases.