Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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fracture Fractured Pelvic Non-surgical treatment Periacetabular Harrington procedure used for periacetabular impending fractures or periacetabular fractures Proximal femur Resection–reconstruction with modular
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, 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 ). Surgical treatment In GSD, surgery is mainly used to treat complications. The orthopedic surgeon is involved in case of pathological fracture, impending
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radiotherapy. While there is general consensus about the advantages of operating on impending fractures over actual fractures, a clear, international definition of ‘a substantial risk’ has not been defined. 10 To prevent over- and under-treatment, a
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comparison of different features eventually led to the definition provided by the ASBMR in 2010. 7 This is very helpful in cases of complete fracture, but impending fractures must also be diagnosed and treated before they become complete. Recognizing
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and oncologists to establish the correct diagnosis and plan the most favourable treatment accordingly. Our own protocol is presented in Figure 1 . Fig. 1 Diagnostic algorithm at impending fracture (known primary tumour). In cases of an
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excellent mechanical resistance and still represent an option when approaching a pathologic or impending fracture of long bones ( 14 , 15 , 16 , 17 ). However, titanium nails show some limits, especially during the follow-up of patients. First, titanium
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embolization, prior to (impending) fracture stabilization is used to reduce perioperative blood loss. Preoperative embolization of metastases was originally described for hypervascular tumours such as renal cell carcinoma and thyroid carcinoma. 6 , 12
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nailing. Fracture characteristics and patterns in which IMN has been found to be superior are pathological and impending fractures, segmental lesions and fractures in osteopenic bone ( Table 1 ). 11 , 12 A simple middle third transverse fracture is
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–Letterer–Siwe disease). However, surgical intervention is rarely necessary after the necessary biopsy owing to its aggressive appearance to exclude Ewing's sarcoma, neuroblastoma and osteomyelitis. Only lesions threatening stability with impending fracture force
