What are pathological fractures caused by tumors? Information about the diagnosis, surgical treatment options, and follow-up process for fractures caused by bone tumors and metastases.
Pathological fractures are fractures that occur due to weakening of bone tissue as a result of disease, and which would not normally lead to a fracture from minor trauma or sometimes without significant trauma. Bone tumors and bone metastases are among the important diseases that can cause pathological fractures.
In particular, the spread of breast, lung, prostate, kidney, and thyroid cancers to the bones can affect the strength of the bone structure. In addition, primary bone tumors and some benign bone lesions can also lead to pathological fractures.
Tumor-related pathological fractures are frequently seen in the thigh (femur) and upper arm (humerus) bones. Symptoms such as pain, limited movement, swelling, and difficulty bearing weight may occur in the affected area. Some patients may have long-standing bone pain before the fracture occurs.
Diagnosis and Evaluation
In the evaluation of pathological fractures, the patient's complaints, existing diseases, cancer history, and physical examination findings are considered together.
X-ray is the primary imaging method used to assess the location of the fracture and changes in bone structure. Computed tomography (CT) and magnetic resonance imaging (MRI) are used when necessary.
Additional imaging studies may be planned to investigate the extent of bone tissue damage and possible tumor involvement in other areas.
In cases where the cause of the fracture is unknown or a primary bone tumor is suspected, biopsy and pathological examination may be necessary. Especially in patients where a tumor diagnosis has not yet been confirmed, appropriate oncological evaluation before surgical fixation is important.
Treatment Approaches
Treatment of pathological fractures caused by tumors is planned according to the location of the fracture, the damage to the bone tissue, the type of tumor, the extent of the disease, and the patient's general health condition.
The main goal of treatment is to treat the fracture appropriately, ensure bone stability, reduce pain, and preserve the patient's mobility functions as much as possible.
In patients requiring surgical treatment, intramedullary nail, plate and screw systems or prosthetic applications may be used depending on the characteristics of the fracture. In selected cases where the bone tissue is severely affected, tumor removal and bone reconstruction may be necessary.
In patients who have not yet experienced a fracture but whose bone strength is significantly reduced, protective surgical fixation to prevent fracture may also be considered.
In fractures due to bone metastases, radiotherapy, systemic oncological treatments, and medications that support bone tissue may be included in the treatment plan.
The diagnosis and treatment process is evaluated in collaboration with relevant specialties such as orthopedics and traumatology, medical oncology, radiation oncology, and radiology.
After treatment, bone stability, pain status, movement functions, and the course of the disease are regularly monitored.