Premium Nahrungsergänzungsmittel | artgerecht

Pathological Fracture – Causes, Symptoms & Treatment

A pathological fracture is a bone break caused by an underlying bone disease, often occurring without significant external force or trauma.

Regular tips about health Regular tips about health

Things worth knowing about "Pathological fracture"

A pathological fracture is a bone break caused by an underlying bone disease, often occurring without significant external force or trauma.

What is a Pathological Fracture?

A pathological fracture is a bone fracture that occurs as a result of an underlying disease that has weakened the bone structure, rather than from a significant traumatic event. Because the bone is already compromised by a pre-existing condition, even minor stress, everyday movements, or in some cases no apparent force at all can cause the bone to break. Pathological fractures are clinically important because they often signal a serious underlying medical condition that requires prompt evaluation and treatment.

Causes

Pathological fractures can arise from a variety of conditions that weaken bone integrity:

Osteoporosis

Osteoporosis is the most common cause of pathological fractures worldwide. As bone density decreases with age or due to other factors, bones become brittle and prone to fracture. The spine, hip, and wrist are particularly vulnerable.

Bone Metastases

Cancers that commonly spread to bone – including breast, prostate, lung, kidney, and thyroid cancer – can form bone metastases. These lesions weaken the affected bone locally, making fractures in areas such as the femur, spine, or humerus more likely.

Primary Bone Tumors

Both benign and malignant primary bone tumors, such as osteosarcoma, Ewing sarcoma, enchondroma, and bone cysts, can compromise bone strength to the point of fracture.

Bone Infections

Osteomyelitis, a bacterial or fungal infection of bone tissue, can destroy bone structure locally and significantly increase fracture risk.

Metabolic Bone Diseases

Conditions such as Paget's disease of bone, hyperparathyroidism, osteomalacia, and chronic kidney disease disrupt normal bone metabolism and reduce mechanical bone strength.

Other Causes

Long-term use of corticosteroids (medication-induced osteoporosis)
Prior radiation therapy to bone (radiation osteonecrosis)
Rare genetic disorders such as osteogenesis imperfecta (brittle bone disease)

Symptoms

The symptoms of a pathological fracture are similar to those of a traumatic fracture but often occur without a clear injury event:

Sudden, severe pain at the fracture site
Swelling, tenderness, or bruising over the affected area
Limited range of motion or inability to bear weight
Visible deformity or abnormal bone alignment
In vertebral fractures: acute back pain, loss of height, or development of a stooped posture (kyphosis)
In severe cases: neurological symptoms such as numbness, weakness, or paralysis due to nerve compression

It is worth noting that patients often experience a period of increasing local pain before the fracture occurs, which may reflect the progression of the underlying bone disease.

Diagnosis

Diagnosing a pathological fracture involves both confirming the fracture and identifying the underlying cause:

X-ray: Initial imaging to visualize the fracture and any existing bone abnormalities
Computed Tomography (CT): Provides detailed structural information about the fracture and surrounding tissue
Magnetic Resonance Imaging (MRI): Particularly useful for detecting tumors, metastases, and bone marrow involvement
Bone scintigraphy: Whole-body scan to detect additional bone lesions
Blood tests: Including bone turnover markers, tumor markers, calcium levels, and complete blood count
Biopsy: Tissue sampling for histological confirmation when a tumor or malignancy is suspected

Treatment

Treatment of a pathological fracture must address both the fracture itself and the underlying condition:

Conservative Management

Stable fractures, particularly those due to osteoporosis, may be managed conservatively with immobilization, pain management, and targeted treatment of the underlying disease (e.g., bisphosphonates, calcium, and vitamin D supplementation).

Surgical Treatment

Surgical stabilization is frequently required. Common approaches include:

Osteosynthesis: Internal fixation using nails, plates, or screws
Endoprosthesis: Joint replacement, particularly for hip fractures
Vertebroplasty / Kyphoplasty: Minimally invasive stabilization of vertebral fractures using bone cement

Oncological Therapy

When fractures are related to cancer, fracture treatment is combined with systemic therapies such as chemotherapy, radiation therapy, or bone-targeted agents like bisphosphonates (e.g., zoledronic acid) or RANK-L inhibitors (e.g., denosumab) to reduce the risk of further skeletal complications.

Rehabilitation

Physiotherapy and rehabilitation are essential after treatment to restore mobility, prevent further fractures, and maintain the patient's quality of life.

References

Coleman, R.E. et al.: Bone health in cancer: ESMO Clinical Practice Guidelines. Annals of Oncology, 2020;31(12):1650–1663.
Kanis, J.A. et al.: European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International, 2019;30(1):3–44.
Rougraff, B.T.: Pathologic Fractures. In: Orthopaedic Knowledge Update, American Academy of Orthopaedic Surgeons (AAOS), 2021.

Building Blocks for a Healthy Life

As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.

Most read entries

3 Posts in this encyclopedia category