title: Hypertrophic non-union of a pathological forearm fracture secondary to multiple myeloma: a case report.
abstract: Skeletal lesions in multiple myeloma are predominantly lytic and when non-union of pathological fractures occur it is typically atrophic. We report a lady of 61 years of age with myeloma who presented with a pathological fracture through an ulnar myeloma deposit. The fracture was immobilised initially then irradiated. Nine months later she re-presented with marked forearm pain particularly on rotation. Radiographs demonstrated a hypertrophic non-union of a pathological fracture with a typical elephant's hoof appearance. The fracture was immobilised using an ulnar nail. Whilst non-unions in metastatic malignancy are typically atrophic, just occasionally hypertrophic non-unions can occur. Management principles remain the same with stabilisation of the entire bone and early mobilisation being appropriate.
authors.affiliation: School of Medical Sciences, Bangor University, Bangor LL572AS, UK. tosanwumi@hotmail.com
authors.forename: Tosan
authors.initials: T
authors.lastname: Okoro
authors.forename: Robert U
authors.initials: RU
authors.lastname: Ashford
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