ABSTRACT
Pathological fractures occur in diseased, weakened bone following minimal trauma or, occasionally, spontaneously. Pre-existing disease includes metabolic bone disease, metastatic malignant disease, primary benign or malignant bone tumours and infection. Osteoporosis is the most common cause. Primary malignant bone tumours require specialist management and are beyond the scope of this chapter. The term ‘insufficiency fracture’ is used for fractures through bone weakened by a process other than neoplasia. Repeated loading may cause a ‘stress fracture’, most commonly in the athlete or military recruit’s foot or tibia (this term is a misnomer and a stress fracture is not really a pathological fracture).
