Management of pathologic fractures

The principles of management of pathologic fractures in the long bones are reviewed, and a series of 45 fractures treated by internal fixation is compared with 26 fractures treated by other nonsurgical procedures. Internal fixation and radiation therapy provide better and longer lasting palliative results in these patients, provided clear indications for this method of management are carefully evaluated. Relief of pain is observed in over 80% of the patients and satisfactory healing and functional results in about 75%. The value of prophylactic fixation and irradiation of large osteolytic lesions in weight-bearing bones with a high risk of fracture is emphasized.