Die Pathologische Fraktur aus sicht des Orthopäden und Unfallchirurgen

Abstract

Owing to the demographic development, the number of patients in Germany with cancer has been steadily rising over recent decades. While primary bone tumours remain rare, the number of skeletal metastases is clearly increasing. When diagnosis of skeletal metastasis is late, pathologic fractures are not uncommon; prediliction sites for fracture are the vertebral column, the pelvis, the femur and the humerus. This review gives an overview of the necessary diagnostic steps when a pathologic fracture is suspected and of the different treatment strategies. The type and extent of the treatment depends for example on the tumour entity, the time of occurrence of skeletal metastasis, the stage of disease and the site of the fracture. The aim of surgical treatment is full weight-bearing on the involved extremity until the patient's death. Revision surgery due to tumour progression, pseudarthrosis and / or implant failures should be avoided because of an additional limitation of life quality in the palliative situation. © 2008 Springer Medizin Verlag.