Abstract
Evaluation and management of suspected pathologic fractures, secondary to metastatic
disease, require a comprehensive understanding of the underlying disease process and
a multidisciplinary treatment approach. Recognition of a pathologic fracture can be
challenging, and the diagnosis today remains often missed, but is necessary for appropriate
care. The incidence of cancer in the United States is on the rise, and with advances
in medical and surgical care the prevalence of cancer is increasing as well. This
will result in a similar trend of increased incidence and prevalence of metastatic
disease requiring treatment from orthopaedic surgeons. The proximal femur is the most
common location for metastatic lesions in the appendicular skeleton, and as such sees
a disproportionate number of pathologic fractures. This site of injury is particularly
challenging to manage due to the transmission of high forces through this region during
ambulation. A combination of adjunct therapies and surgical intervention will maximize
the outcomes for these patients. Obtaining a tissue diagnosis, especially in the setting
of a solitary bone lesion, is a crucial and required early step in this process.
Keywords
pathologic - metastases - fracture - femur - hip
