Imagine that you are walking inside your house and your foot gets caught on a corner of a carpet or a small step. Or let's say you hit the leg of a chair a little hard. Normally, a large bone in our arm or leg doesn't break from something like that, right? However, some people's bones are a little weak, so even a small thing like that can break them. That's what we are talking about today (Pathologic Fracture).
What is this (Pathologic Fracture)?
Simply put, a Pathologic Fracture is a bone fracture . But this doesn't just happen. Your bones have become weaker due to another medical condition in your body, making them more likely to break than normal bones. Sometimes doctors also call this a Pathologic Fracture.
Just think, a simple fall, a minor accident while playing sports, or even a minor impact that the body can normally withstand, can cause a pathologic fracture in someone with weakened bones. It's like a piece of rotten wood that can break with even the slightest pressure.
What types of bones are most affected by this?
This condition, called a pathologic fracture, can actually occur in any bone in the body. However, it is most commonly seen in bones that are normally very strong and do not break easily . For example:
- Vertebrae : These are the small bones that make up our spine.
- Pelvis
- Humerus : This is the bone in the upper part of the arm from the shoulder to the elbow.
- Femur : The longest and strongest bone in our body.
- Tibia : The thick bone of the leg from the knee to the ankle.
- Fibula : A thin bone that runs parallel to the tibia.
Normally, even if you slip a little while doing household chores or lose your balance while going down a flight of stairs, these large bones in our arms and legs rarely break. However, if you have a medical condition that weakens your bones, even a minor incident like that can cause a pathologic fracture .
Sometimes, surgery may be needed to repair the broken bone. Or, surgery may be needed to prevent a pathologic fracture before it occurs. Your doctor will also recommend other treatments for the condition that is causing your bones to weaken. The time it takes to heal depends on which bone is broken and what caused it.
What are the symptoms of a Pathologic Fracture?
The symptoms of a Pathologic Fracture are very similar to those of a normal fracture. They are:
- Pain : Severe, unbearable pain may occur.
- Swelling : The area where the bone is broken will swell.
- Tenderness: Pain is felt when touched or pressed.
- Inability to move normally : The affected body part cannot be moved or used normally.
- Bruising or skin discoloration : Sometimes it can look blue/purple.
- A deformity or lump : An unusual shape or lump may be seen at the site of the fracture.
The most important thing is that even if you have these symptoms, you should definitely seek medical advice to know exactly whether it is a Pathologic Fracture or not, and what the cause is.
Why does this happen? (Pathologic Fracture) Causes
The main cause of a Pathologic Fracture is, without you even knowing it, the presence of a medical condition in your body that makes your bones unnaturally weak . Two of the main causes of this are osteoporosis and bone tumors.
Due to osteoporosis
Osteoporosis is a disease in which bones gradually become porous and brittle . It's as if they've just been hollowed out from the inside. This makes the bones less strong and more likely to break. Many people only find out they have osteoporosis after they break a bone. This is because there may be no obvious symptoms of the disease at first .
Women and people over the age of 65 are especially at risk of developing osteoporosis. You may have heard that our grandparents would break an arm or a leg even if they fell a little. One of the main reasons for that is osteoporosis.
Due to bone tumors or lesions
A tumor is a solid mass of abnormal cells that forms anywhere in our body. Some of these can be cancerous (malignant), while others can be non-cancerous (benign). Bone lesions are not solid tumors, but rather abnormal cell deposits that weaken the bone.
A (Pathologic Fracture) can occur if a tumor or lesion develops within a bone, or if it spreads to the bone from somewhere else. Then the natural shape and strength of the bone are weakened.
- Malignant tumors: If you have bone cancer (sarcoma), it can grow in the bone itself. However, it is more common for cancer to spread to the bones from another part of the body (e.g., breast, lung, prostate) (bone metastasis).
- Benign bone tumors: These are tumors that do not contain cancer cells, but grow in the bones. There are different types. Any of these types can weaken the bone (pathologic fracture).
How do you accurately diagnose this condition?
A doctor will diagnose a pathologic fracture by physically examining you and performing various imaging tests .
At least one of the following imaging tests will be done to examine your injured bone and the surrounding area:
- X-rays : These can clearly show bone fractures.
- MRI Scan (MRI - Magnetic Resonance Imaging) : This allows you to see not only the bones, but also the surrounding soft tissues and things like tumors.
- CT scan (Computed Tomography scan) : This can also produce detailed images of the bones and surrounding tissues.
Depending on the cause of the fracture, you may need to have further tests. For example:
- Blood tests for cancer : Check for cancer markers.
- Biopsy : Taking a small sample of tissue or tissue and examining it under a microscope.
- Bone density test (DXA scan) : This is especially important to check for osteoporosis.
How do you treat a (Pathologic Fracture)?
The treatment for a Pathologic Fracture depends on which bone is broken and what caused it . Like all other fractures, the following treatments are used for Pathologic Fractures:
- Immobilization: You may need to wear a cast or splint. How long you need to wear one will depend on the type of broken bone. Most people will need to wear a cast for several weeks. You may also need to have X-rays to check that the bone is healing properly.
- Surgery: Some pathologic fractures require surgery. The surgeon `sets` the broken bone and fixes it in place until it heals and comes back together. The most common method is `internal fixation`. This means that the surgeon inserts metal plates, screws, or pins into the bone. Sometimes these can remain in place for life. Some people may need another surgery to remove them later.
- Radiation therapy: If the doctor can find a tumor or lesion before the bone breaks, radiation therapy can be given to destroy it. This radiation destroys the abnormal growth in the bone and allows healthy bone cells to grow back. Radiation therapy can also be given after surgery for a pathologic fracture caused by bone cancer.
- Treating the underlying condition: This is very important . You may also need other treatments to treat the underlying condition or tumor that caused the pathologic fracture. For example, if you have cancer, you will need to work with an oncologist. Your doctor will explain what to expect and what kind of treatment you will need.
Other complications that may occur due to Pathologic Fracture
Pathologic fractures, like other fractures, can cause certain complications. Some of them are:
- Acute Compartment Syndrome (ACS): This is when pressure inside a muscle increases and blood flow to the tissue is cut off. This can cause permanent muscle and nerve damage.
- Malunion: When broken bones do not come together properly during healing.
- Nonunion: A bone that has not fully or partially come back together.
How long does it take for a (Pathologic Fracture) to heal?
The time it takes for a Pathologic Fracture to heal depends on several factors:
- Which bone was broken?
- What causes bone fractures?
- What kind of treatment did you need?
- Have you had any other injuries?
It often takes several months for a broken bone to heal. Talk to your doctor or surgeon about a time frame that is right for your specific situation. Your recovery time will also depend on the underlying condition that caused the fracture. Even after the broken bone heals, conditions such as osteoporosis, benign bone tumors, or cancer may require additional time to treat.
Can these types of fractures be prevented?
Yes, it can be prevented to some extent. If your doctor can find a tumor, lesion, or signs of osteoporosis before a bone breaks, there is a good chance that a pathologic fracture can be prevented. Sometimes, tumors and conditions that weaken the bones can cause pain before a bone breaks. This is called an "impending pathological fracture," which means "a bone fracture that is likely to happen soon." If you feel any new bone pain , see a doctor right away.
Sometimes, surgery (called prophylactic fixation) can be done to remove a tumor or lesion before the bone breaks. If you have osteoporosis or another condition that affects bone density, your doctor may recommend medications and other treatments to strengthen your bones and reduce your risk of fractures.
It's important to have a physical exam once a year (or as your doctor recommends). Also, if you have any new symptoms, such as pain around a bone or pain when you press on it, tell your doctor right away. If you think you're at risk, ask your doctor about genetic testing for cancer or a bone density test, which can detect osteoporosis early.
When should you go to the hospital immediately? (In case of an emergency)
If you think you have a broken bone, especially if you have these symptoms, go to the emergency room immediately :
- Very severe pain.
- If you can't move a part of your body.
- If a part of the body looks strange, or seems out of place.
- If the bone is visible through the skin.
- If there is swelling.
- If new bruises have appeared along with these symptoms.
Questions to ask your doctor
You can ask your doctor questions like these:
- What bone is broken?
- Is this a Pathologic Fracture or another type of fracture?
- Will I need more treatment?
- What medical condition caused this fracture?
- Do I have cancer?
Breaking a bone is always scary. It can be even more scary when it happens because of a medical condition you don't know about. Your doctor will explain what caused the bone fracture, how you can help your body heal, and what treatments are needed to control the underlying cause.
Never be afraid to ask questions. The better you understand your health condition, the more confident you will be in facing what lies ahead.
Finally (Take-Home Message)
Pathologic Fracture is a serious condition. However, it can be managed with proper diagnosis and treatment . The most important thing is to take care of your bone health and seek medical attention if you experience any unusual symptoms. Be open with your doctor, ask your questions, and follow your treatment plan. You will be able to cope with this condition successfully.
` Pathologic Fracture, Bone Fracture, Weak Bones, Osteoporosis, Bone Tumor, Bone Cancer, Bone Health
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