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Pathologic fracture
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<h2 id="cause">Cause</h2> <p>Pathologic fractures in children and adolescents can result from a diverse array of disorders namely; metabolic, endocrine, neoplastic, infectious, immunologic, and genetic <a href="/facts/Skeletal_dysplasia/YnW1Gpe3">skeletal dysplasias</a>. </p> <ul><li><a href="/facts/Primary_hyperparathyroidism/4JbGepnw">Primary hyperparathyroidism</a></li> <li><a href="/facts/Simple_bone_cyst/9TnI0a5K">Simple bone cyst</a></li> <li>Aneurismal <a href="/facts/Bone_cyst/bd6pyBbd">bone cyst</a></li> <li>Osteoporosis</li> <li>Chronic <a href="/facts/Osteomyelitis/FUzsmRPf">osteomyelitis</a></li> <li><a href="/facts/Osteogenesis_imperfecta/jKr64on7">Osteogenesis imperfecta</a></li> <li><a href="/facts/Osteomalacia/dQbx3aRe">Osteomalacia</a></li> <li><a href="/facts/Rickets/Fd1r1k78">Rickets</a></li> <li><a href="/facts/Renal_osteodystrophy/CTDGxb2v">Renal osteodystrophy</a></li> <li><a href="/facts/Malignant_infantile_osteopetrosis/Ua9ETHNj">Malignant infantile osteopetrosis</a></li> <li><a href="/facts/Juvenile_osteoporosis/p4tTaq8d">juvenile osteoporosis</a></li> <li><a href="/facts/Juvenile_rheumatoid_arthritis/QLkC6CGD">juvenile rheumatoid arthritis</a></li></ul> <h3>Miscellaneous causes</h3> <ul><li><a href="/facts/Monostotic_fibrous_dysplasia/RGgKX43Q">Monostotic fibrous dysplasia</a></li> <li><a href="/facts/Eosinophilic_granuloma/vQ11e5Nf">Eosinophilic granuloma</a></li> <li>Bone atrophy secondary to diseases like <a href="/facts/Polio/6dYyXUhE">polio</a><a class="footnote-ref" id="fnref:3" href="#fn:3"><sup>3</sup></a></li></ul> <h2 id="diagnosis">Diagnosis</h2> <p>In circumstances where other pathologies are excluded (for example, cancer), a pathologic fracture is diagnostic of osteoporosis irrespective of <a href="/facts/Bone_mineral_density/poUvLR69">bone mineral density</a>. </p> <h2 id="management">Management</h2> <p>Based on <a href="/facts/Mirel%27s_score/CGAxQCrc">Mirel's score</a> (if the score is more than 8), bone fixation should be done prophylactically. Fixation is done by internal fixation rather than conservatively, along with treatment of the underlying cause.<a class="footnote-ref" id="fnref:4" href="#fn:4"><sup>4</sup></a> </p><p>Once a fracture has occurred, intramedullary fixation is the usual surgical management for certain long bones, such as the femur, tibia, and fibula.<a class="footnote-ref" id="fnref:5" href="#fn:5"><sup>5</sup></a> For pathological fractures in the setting of metastatic disease where there is a need for postoperative radiation, a carbon fiber implant may be preferred due to its radiolucency, allowing better visualization of the affected area on x-ray imaging.<a class="footnote-ref" id="fnref:6" href="#fn:6"><sup>6</sup></a> </p> <h2 id="external-links">External links</h2> <h2 id="references">References</h2> <ol> <li id="fn:1"><p>Salehi, Sana; Abedi, Aidin; Gross, Jordan S.; Gholamrezanezhad, Ali (2019-06-22). "Prayer's fracture: rare cases of knee insufficiency fracture in non-weight-bearing femoral condyle". Clinical Imaging. 58: 80–83. doi:10.1016/j.clinimag.2019.06.013. ISSN 0899-7071. PMID 31279988. S2CID 195830673. <a href="https://www.clinicalimaging.org/article/S0899-7071(19)30126-3/abstract" target="_blank">https://www.clinicalimaging.org/article/S0899-7071(19)30126-3/abstract</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li> <li id="fn:2"><p>Vanasse, Alain; Dagenais, Pierre; Niyonsenga, Théophile; Grégoire, Jean-Pierre; Courteau, Josiane; Hemiari, Abbas (2005). "Bone mineral density measurement and osteoporosis treatment after a fragility fracture in older adults: regional variation and determinants of use in Quebec". BMC Musculoskeletal Disorders. 6 (1): 33. doi:10.1186/1471-2474-6-33. ISSN 1471-2474. PMC 1187894. PMID 15969760. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1187894" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1187894</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></p></li> <li id="fn:3"><p>Maheswari. Essential Orthopedics (3 ed.). Jaypee Publications. p. 4. <a href="#fnref:3" class="footnote-back-ref">↩</a></p></li> <li id="fn:4"><p>Mirels H (October 2003). "Metastatic disease in long bones: A proposed scoring system for diagnosing impending pathologic fractures. 1989". Clin. Orthop. Relat. Res. (415 Suppl): S4–13. doi:10.1097/01.blo.0000093045.56370.dd. PMID 14600587. S2CID 43255503. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:4" class="footnote-back-ref">↩</a></p></li> <li id="fn:5"><p>Hogan WB, Bluman EM. Brostrom-Gould procedure for lateral ankle instability. J Med Insight. 2024;2024(23). doi:10.24296/jomi/23. <a href="#fnref:5" class="footnote-back-ref">↩</a></p></li> <li id="fn:6"><p>Rizk, PA; Werenski, JO; Lozano-Calderon, SA (2024). "Carbon fiber implant for fixation of a pathologic subtrochanteric fracture". J Med Insight. 2024 (443). doi:10.24296/jomi/443. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:6" class="footnote-back-ref">↩</a></p></li> </ol>