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Management of Bone Metastases pp 115–122Cite as

Pathologic Versus Impending Fracture

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Abstract

The constant improvement of medical therapies has led to the longer survival of patients affected by carcinoma and a consequent increase in the number of patients with bone metastasis. In the natural history of bone metastatic patients they Skeletal Related Events (SREs) are likely to occur. SREs are: pathologic fracture of the long bones, the need of surgical procedures on the bone, spinal compression, and radiotherapy on the bone. SREs have a well-documented negative impact on clinical outcomes and on pain, reduce the quality of life and survival, and increase morbidity. The most frequent complication among SREs is the pathological fracture, which is defined as a fracture that occurs spontaneously or with a low-energy trauma in the site of a preexisting bone lesion. For the patient with bone metastasis, a pathological fracture is always a dramatic event and should be considered a matter of urgency in the orthopedic treatment of these patients. The aim of a high quality of care is to prevent a pathologic fracture; given that the bone lesions are known, these should be treated before the bone fractures with a preventive osteosynthesis. This imminent risk of fracture that may occur in daily activities is a specific diagnosis and is given the name impending fracture.The aim of this chapter is to focus on different aspects of pathologic and impending fracture, including diagnostic and clinical aspects, the impact on survival and on health resource utilization.

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Author information

Authors and Affiliations

  1. Traumatology and Orthopaedic Unit, “Fatebenefratelli - Isola Tiberina” Hospital, Rome, Italy

    Maria Silvia Spinelli

  2. General Direction of Health Program, Italian Ministry of Health, Rome, Italy

    Andrea Piccioli

Authors
  1. Maria Silvia Spinelli
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  2. Andrea Piccioli
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Editor information

Editors and Affiliations

  1. Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Rome, Italy

    Vincenzo Denaro

  2. Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Rome, Italy

    Alberto Di Martino

  3. General Direction of Health Program, National Ministry of Health of Italy, Rome, Italy

    Andrea Piccioli

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Spinelli, M.S., Piccioli, A. (2019). Pathologic Versus Impending Fracture. In: Denaro, V., Di Martino, A., Piccioli, A. (eds) Management of Bone Metastases. Springer, Cham. https://doi.org/10.1007/978-3-319-73485-9_11

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  • DOI: https://doi.org/10.1007/978-3-319-73485-9_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-73484-2

  • Online ISBN: 978-3-319-73485-9

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