Archives of Orthopaedic and Trauma Surgery

, Volume 116, Issue 4, pp 221–224 | Cite as

Prediction of pathological subtrochanteric fractures due to metastatic lesions

  • P. D. S. Dijkstra
  • M. Oudkerk
  • T. Wiggers
Original Article


We report a radiographic review of 54 consecutive patients with 24 impending and 30 actual pathological fractures due to metastatic bone lesions in the subtrochanteric femoral region. In an attempt to develop criteria for metastatic lesions at risk of fracturing, the following variables based on anteroposterior and lateral X-rays were considered: appearance of the lesion, width of the lesion, ratio between width of the lesion and bone width, length of the lesion, length of cortex involvement, proportion of transverse cortical bone destroyed and local pain. Nearly all (99%) of the lesions were radiographically classified as lytic. In 27 cases (50%) they were radiographically unmeasurable. Maximal longitudinal cortical destruction showed a difference between patients with an actual or impending fracture. Prophylactic internal fixation of pathological subtrochanteric fractures due to metastatic lesions has to be considered in cases of increasing pain. If the conventional X-ray can not be evaluated, a computed tomography (CT) scan has to be considered.


Public Health Compute Tomography Cortical Bone Internal Fixation Metastatic Lesion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • P. D. S. Dijkstra
    • 1
  • M. Oudkerk
    • 2
  • T. Wiggers
    • 1
  1. 1.Department of Surgical Oncology, Dr. Daniel den Hoed Cancer CenterUniversity Hospital RotterdamRotterdamThe Netherlands
  2. 2.Department of Radiology, Dr. Daniel den Hoed Cancer CenterUniversity Hospital RotterdamThe Netherlands

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