I.

PATHOLOGIC FRACTURE

DEFINITION

A pathologic fracture is a broken bone that’s caused by a disease, rather than an injury. Some

conditions weaken your bones, which makes them more likely to break. Everyday things, such as

coughing, stepping out of a car, or bending over can fracture a bone that’s been weakened by an

illness.

Pathological fractures in children can occur as a result of a variety of conditions, ranging from

metabolic diseases and infection to tumors. Fractures through benign and malignant bone tumors

should be recognized and managed appropriately by the treating orthopedic surgeon. The most

common benign bone tumors that cause pathological fractures in children are unicameral bone cysts,

aneurysmal bone cysts, non-ossifying fibromas and fibrous dysplasia. Although pathological fractures

through a primary bone malignancy are rare, these should be recognized quickly in order to achieve

better outcomes. A thorough history, physical examination and review of plain radiographs are crucial

to determine the cause and guide treatment. In most benign cases the fracture will heal and the lesion

can be addressed at the time of the fracture, or after the fracture is healed. A step-wise and

multidisciplinary approach is necessary in caring for pediatric patients with malignancies. Pathological

fractures do not have to be treated by amputation; these fractures can heal and limb salvage can be

performed when indicated.