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Trauma
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Pathologic Fracture Management

Metastatic Disease

A 62-year-old woman with known breast cancer presents with progressive right thigh pain. She has no history of trauma. Plain radiographs show a lytic lesion in the proximal femoral diaphysis with 60% cortical destruction. The lesion measures 4 cm and causes moderate pain with activity. There is no fracture present. Regarding impending pathologic fractures and the Mirels scoring system:

Mark each as TRUE or FALSE

A

The Mirels scoring system assesses four criteria: anatomic site (1-3 points), nature of lesion (blas...

B

Upper extremity locations (humerus) score 1 point while lower extremity peritrochanteric lesions sco...

C

The Mirels score ranges from 1-10 points; a score of 7 or greater mandates prophylactic fixation; bl...

D

Prophylactic fixation of impending fractures has significant advantages over treatment after fractur...

E

Before prophylactic fixation, comprehensive staging is essential: whole-body bone scan or PET-CT for...

Answer the questions to see explanations

Click T (True) or F (False) for each option