ABSTRACT
This chapter focuses on evaluation and management of pathological fractures occurring secondary to metastatic and primary neoplastic lesions of bone. Patients with fragility fractures frequently require management in a multidisciplinary setting; in most trauma units, early orthogeriatric input is provided. The goals of pathological fracture management have therefore advanced from limited palliation to full restoration of function. Humeral diaphyseal pathological fractures can generally be treated with intramedullary nailing. Upper limb pathological fractures can usually be managed non-operatively, whereas those in the lower limb frequently require fixation. Management of pathological fracture or impending fracture through a giant cell tumour is aimed at removing the lesion while preserving the adjacent joint. The management of a pathological fracture through a primary bone tumour should always be discussed with the local tertiary referral bone tumour unit. A pathological fracture is one occurring through abnormally weak or diseased bone, such that failure occurs during normal activity or minor trauma.
