LAUSR

ABSTRACT Patients commonly present to orthopaedic surgeons with suspicious and low-energy mechanisms of injury for long bone fractures. The vast majority of tumor-related pathologic fractures in patients over 40 years of age are due to metastatic disease. Though rare, the treating surgeon should always consider the possibility of a primary bone tumor. Obtaining a tissue sample is a required early step in the surgical process following the principles of biopsy tract selection. An adequate tissue biopsy is also necessary for the diagnosis of a primary source of metastatic disease if otherwise unknown. These patients often require adjuncts to surgery including bisphosphonate treatment, anticoagulation, radiation therapy, chemotherapy, and follow up with multiple medical specialists for continuing care. The surgical treatment plan is based on the location of the fracture, and various options are available depending on whether the metastatic disease is present in the diaphysis, metaphysis, or epiphysis of long bones. The orthopaedic surgeon should have a working knowledge of proper identification and treatment principles of metastatic disease in long bones to properly assist in patient care delivery. .