title: Operative management of impending pathological fractures: a critical analysis of therapy.
abstract: BACKGROUND
  Evident and impending pathological fractures should be stabilised operatively because patients are in serious pain and debilitated for their remaining life span.
  
  
  METHODS
  We evaluated survival and functional results after operative therapy. A retrospective study was conducted concerning 116 patients with 152 impending pathological fractures.
  
  
  RESULTS
  Of all operated patients, postoperatively 79% regained walking capacity and 60% required no or only occasional analgesic drugs. Patients operated on for impending pathological fractures showed better functional results, as well as those operated with the additional use of polymethylmethacrylate (PMMA). Prophylactic use of antibiotics reduced the number of infectious complications significantly. The median survival after operative therapy was 15 months.
  
  
  CONCLUSIONS
  We conclude that impending pathological fractures should be operatively stabilised, if possible, with the additional use of PMMA because of better functional results.
authors.affiliation: Department of Surgery, University Hospital Nijmegen, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Van Geffen
authors.forename: T
authors.initials: T
authors.lastname: Wobbes
authors.forename: R P
authors.initials: RP
authors.lastname: Veth
authors.forename: W A
authors.initials: WA
authors.lastname: Gelderman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000150:complications* / Q000473:pathology / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology; D002648:Child; D005260:Female; D005593:Fracture Fixation, Internal; D005598:Fractures, Spontaneous / Q000517:prevention & control* / Q000601:surgery*; D006801:Humans; D008297:Male; D008768:Methylmethacrylates; D008875:Middle Aged; D019736:Prostheses and Implants; D012189:Retrospective Studies
chemical_list: D008768:Methylmethacrylates