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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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, pain is the most common symptom, followed by impending or actual pathological fractures in 10%-25% of patients. 5 Pathological fractures of the femur, 75% of which present in the proximal part, are roughly 3.5 times as common as fractures of the

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Maria A. Smolle Department of Orthopaedics and Trauma, Medical University of Graz, Austria

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Dimosthenis Andreou Department of General Orthopaedics and Tumour Orthopaedics, University Hospital Muenster, Germany

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Per-Ulf Tunn Tumour Orthopaedics, HELIOS Klinikum Berlin-Buch, Germany

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Andreas Leithner Department of Orthopaedics and Trauma, Medical University of Graz, Austria

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, NJ, USA) reviewed for implant fracture (112 distal femur, 53 proximal tibia, 40 proximal femur, 13 total femur, three distal femur + proximal tibia) – system failure in 27 patients (12%), most commonly in the distal femur ( n = 21) – mean time to

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Olga D. Savvidou First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Panagiotis Koutsouradis Department of Orthopaedic Surgery, 417 Veterans Hospital (NIMTS), Athens, Greece

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George D. Chloros First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Ioannis Papanastasiou First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Thomas Sarlikiotis First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Aggelos Kaspiris Laboratory of Molecular Pharmacology/ Sector for Bone Research, School of Health Sciences, University of Patras, Patras, Greece

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Panayiotis J. Papagelopoulos First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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functional outcome and sometimes it is challenging to achieve ‘safe’ oncological margins. Benign lesions are more common than malignant ones. They usually affect the proximal ulna and radius. 2 The commonest benign tumours around the elbow joint are

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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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pathologic fractures until the healing occurs ( 2 , 3 ) ( Fig. 1 ). Figure 1 Male, 7 years old. (A) Pathologic fracture on simple bone cyst of the left proximal humerus. (B) Complete healing after three percutaneous corticosteroid injections

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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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Hornicek FJ van Dijk CN Bramer JA Schwab JH . Outcome after fixation of metastatic proximal femoral fractures: a systematic review of 40 studies . J Surg Oncol 2016 ; 114 : 507 – 519 . 12. Campanacci M

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Olga D. Savvidou First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Panagiotis Koutsouradis Department of Orthopaedic Surgery, Mediterraneo Hospital, Athens, Greece

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Ioanna K. Bolia First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Angelos Kaspiris Laboratory of Molecular Pharmacology/Sector for Bone Research, School of Health Sciences, University of Patras, Patras 26504, Greece

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George D. Chloros First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Panayiotis J. Papagelopoulos First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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proximal part of the ulna attached to the tumour. The biopsy confirmed the diagnosis of synovial sarcoma. (E) Post-operative radiographs after tumour resection. However, a pathological fracture of the proximal ulna occurred secondary to radiation therapy

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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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juxtacortical benign lesions such as myositis ossificans, stress fracture, subperiosteal haematoma or abscess, osteochondromas, or BPOP, leading to wrong diagnosis with devastating consequences. This article aims to discuss the clinicopathological and imaging

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