Discuss the basic epidemiology, pathophysiology, presentation, investigation, management and prognosis of pathological fractures

Question 1

True or false? rheumatoid arthritis can be an underlying cause of pathological fractures?

Answer 1

true

Question 2

How could you investigate pathological fractures?

Answer 2

1. X-ray
2. CT scan (complex fractures)
3. MRI (associated soft-tissue injury)

Question 3

are proximal long bones or distal bones more susceptible to pathological fractures?

Answer 3

proximal > distal

50% occur in the femur, 15% in the humerus

Question 4

How do you manage a pathological fracture?

Answer 4

1. immobilise
2. analgesia
3. treat underlying condition

Question 5

what are the underlying carcinogenic causes of pathological fractures?

Answer 5

1. benign tumours
2. malignant tumours (primary and metastasis)
3. myeloma
4. lymphoma

Question 6

what metabolic bone diseases can underly pathological fractures?

Answer 6

1. paget’s disease
2. osteomalacia
3. hyperparathyroidism
4. osteogenesis imperfect

Question 7

Who are mostly affected by pathological fractures?

Answer 7

1. the elderly
2. those with low bone mineral density
   
   1. those with previous fractures

Question 8

Which 4 ways can you immobilise a pathological fracture?

Answer 8

1. plaster
2. splint
3. brace
4. spring

Question 9

How do pathological fractures present?

Answer 9

1. complains of pain
2. deformity of limb
3. swelling/bruising
4. significant tenderness to palpation
5. weakness/numbness due to peripheral nerve function