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Julie J. Willeumier Department of Orthopaedics, Leiden University Medical Centre, The Netherlands

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Yvette M. van der Linden Department of Orthopaedics, Leiden University Medical Centre, The Netherlands

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Michiel A.J. van de Sande Department of Orthopaedics, Leiden University Medical Centre, The Netherlands

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P.D. Sander Dijkstra Department of Orthopaedics, Leiden University Medical Centre, The Netherlands

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bones, three principal surgical treatment options exist: intramedullary nail, plate, or (endo) prosthesis. Intramedullary nails offer several advantages: they protect a long segment of bone, the necessary dissection is relatively small, blood supply to

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Elisa Pala Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Giulia Trovarelli Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Andrea Angelini Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Maria Chiara Cerchiaro Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Pietro Ruggieri Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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allograft (78%) ( 3 ). The association of curettage, bone graft, and elastic stable intramedullary nail (ESIN) appears to be more effective, with a success rate of over 85% ( 3 ) ( Fig. 2 ). Figure 2 Male, 6 years old. (A) Simple bone cyst of the

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Catalin Cirstoiu Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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Bogdan Cretu Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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Sergiu Iordache Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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Mihnea Popa Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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Bogdan Serban Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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Adrian Cursaru Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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tissue after surgery. The treatment of a fracture on a bone metastasis varies depending on the location. Centromedullary nails, cephalomedullary nails, hemiarthroplasty, or total arthroplasties with modular prostheses are the main options ( 7 ) ( Figs 2

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Miklós Szendrői Department of Orthopaedics, Semmelweis University, H-1082 Budapest, Üllői 78/b, Hungary

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Imre Antal Department of Orthopaedics, Semmelweis University, H-1082 Budapest, Üllői 78/b, Hungary

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Attila Szendrői Department of Urology, Semmelweis University, H-1082 Budapest, Üllői 78/b, Hungary

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Áron Lazáry National Center for Spinal Disorders, H-1126 Budapest, Királyhágó u.1., Hungary

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Péter Pál Varga National Center for Spinal Disorders, H-1126 Budapest, Királyhágó u.1., Hungary

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.g. plating with cement augmentation/prosthesis, etc. In this way, irredeemable failures, such as intramedullary nailing spanning the entire length of the bone in cases of primary bone sarcoma, can be avoided. Even though patients with a pathological fracture

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Andrea Angelini Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Ivan Bohacek Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Salata, Zagreb, Croatia

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Mihovil Plecko Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Salata, Zagreb, Croatia

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Carlo Biz Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Giulia Trovarelli Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Mariachiara Cerchiaro Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Giuseppe Di Rubbo Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Pietro Ruggieri Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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AD DF + tibia Arthrodesis (graft + nail) – 24 Neuropathic pain NED, MSTS 77% ( 44 ) 47 M OS DF + partial tibia Arthrodesis (graft + plate) CT 56.4 – NED, MSTS 30 10 M OS

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Stijn E. W. Geraets Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands

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P. Koen Bos Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands

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Johan van der Stok Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands

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fractures vary from minimally invasive procedures such as intramedullary nailing, to extensive open procedures such as joint replacement. These surgical procedures in themselves can result in significant perioperative blood loss, which might be increased due

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Catalin Cirstoiu Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Bogdan Cretu Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Bogdan Serban Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Zsombor Panti Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Mihai Nica Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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the form of special intramedullary nails, have been introduced to prevent the risks associated with the use of external fixation devices. Specific concerns for using bone transport as a reconstruction procedure after sarcoma resections are: the

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Irina-Anca Eremia Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Emergency Medicine, Emergency University Hospital, Bucharest, Romania

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Bogdan Serban Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Orthopaedics and Traumatology, Emergency University Hospital Bucharest, Romania

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Mihnea Popa Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Orthopaedics and Traumatology, Emergency University Hospital Bucharest, Romania

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Adela Iancu Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

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Silvia Nica Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Emergency Medicine, Emergency University Hospital, Bucharest, Romania

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Catalin Cirstoiu Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Orthopaedics and Traumatology, Emergency University Hospital Bucharest, Romania

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with the goal of enhancing the patient's quality of life and reducing discomfort. In order to mitigate the imminent danger of a femur fracture, a procedure called comfort osteosynthesis was conducted using gamma nails (D). This technique was selected

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Olga Savvidou First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
These authors contributed equally to this manuscript

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Olympia Papakonstantinou Second Department of Radiology, National and Kapodistrian University of Athens, Medical School, Attikon University General Hospital, Athens, Greece
These authors contributed equally to this manuscript

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Eleftheria Lakiotaki First Department of Pathology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
These authors contributed equally to this manuscript

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Ioannis Zafeiris First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece

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Dimitra Melissaridou First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece

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Pinelopi Korkolopoulou First Department of Pathology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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Panayiotis J. Papagelopoulos First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
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the posterior femur after tumour resection. (G) The resected specimen. (H) Postoperative radiographs of the femur after resection of the tumour and insertion of an intramedullary femoral nail. The most common radiographic appearance of PAO is

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