Pathologic Fracture Management 

A break in a bone that has been weakened by a disease is considered a pathologic fracture. 
It normally takes heavy impact or stress to break a bone, but some diseases can weaken the underlying area of a bone enough to make it much easier to fracture. A traumatic break is considered a pathological fracture when there is evidence that a disease has weakened the bone in question. Whether a fracture is complete or impending (which simply means the bone is developing what will eventually become a complete fracture), patients undergoing treatment for a pathologic fracture will need to have both the break and the disease carefully managed. 

Conditions Enabling Pathologic Fractures 

A variety of conditions can affect the bone and make pathologic fractures possible for a patient: 

• Bone metastases 
• Multiple myeloma 
• Benign bone tumors 
• Osteomyelitis (bone infection) 

It is important to note that bone cancer (osteosarcoma) is not the only type of cancer that can create a metastasis on the affected bone. Other forms of cancer, such as breast, prostate, lung, thyroid or kidney cancer, can also cause bone metastases to develop. 

Treatment Details 

If a radiograph of the fracture reveals lytic lesions in the area of the fracture—the telltale sign of pathologic fracture—further testing will be ordered to evaluate the fractured area itself and to identify what caused the bone to weaken. This may include imaging tests, biopsies and blood counts. Once the underlying disease is identified, a doctor will be able to determine the best course of action for the patient in question. 

Surgery will be performed to realign, replace or reconstruct the bone in order to improve the patient’s quality of life as they undergo treatment for the disease that deteriorated the bone. Malignant tissue may need to be removed before a surgeon can proceed to fix the bone, as it can sometimes destroy the bone itself. 

Effectiveness 

A patient’s recovery period length and level of pain relief will depend on the nature of the disease that created the pathologic fracture. Most patients who undergo treatment for a complete or impending pathologic fracture will experience pain relief and restoration of function. 

Tampa General Hospital’s Orthopaedic Institute uses cutting-edge technology and the skill of our board-certified, fellowship-trained medical professionals to treat pathologic fractures and help our patients achieve the best possible quality of life while managing the underlying causes.