[Pathological fractures of the extremities].

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-12-01 Epub Date: 2024-11-11 DOI:10.1007/s00113-024-01492-4
Mohamed Omar, Ricarda Stauss
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Abstract

The diagnostics and treatment of pathological fractures of the extremities differ from the approach for conventional fractures. Metastases from breast, bronchial, renal cell and prostate cancer are the predominant cause. Typically, patients present at over 50 years old present after an inadequate trauma. They often report symptoms or swelling in the affected region that already existed before the fracture. An underlying malignant disease is sometimes already known; however, occasionally this is manifested in the form of a fracture. The femur is affected in 74% of cases, followed by the humerus and the tibia. Important indications for the presence of a pathological fracture can even be obtained from conventional radiographs. The diagnostics are supplemented with further modalities depending on the treatment goal. Surgical treatment is the first choice as the fractures do not heal using conservative measures. In this context, a prognosis-stratified approach is recommended.

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[四肢病理性骨折]。
四肢病理性骨折的诊断和治疗方法与常规骨折不同。主要原因是乳腺癌、支气管癌、肾细胞癌和前列腺癌的转移。通常情况下,患者年龄在 50 岁以上,在受到不适当的外伤后发病。他们通常会报告在骨折前就已经存在的受影响区域的症状或肿胀。有时已经知道潜在的恶性疾病,但偶尔也会以骨折的形式表现出来。在 74% 的病例中,股骨受到影响,其次是肱骨和胫骨。甚至可以从传统的放射线照片中获得病理骨折的重要迹象。根据治疗目标的不同,还可采用其他方法对诊断进行补充。手术治疗是首选,因为保守治疗无法使骨折愈合。在这种情况下,建议采用预后分层法。
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