Metastatic bone disease of the pelvis and femur.

Metastatic bone disease involving the pelvis and femur is a common clinical occurrence. A pathologic fracture in this region is a catastrophic event that results in significant pain and loss of function. Recent advances in surgical management of pathologic fractures, resulting in secure fracture stability or stable joint replacement, have allowed these patients to resume their pre-fracture level of activity and ambulation. The surgeon must be familiar with the various devices available, because the choice of surgical procedure depends on the location of the tumor. In selected patients with extensive destruction, methylmethacrylate can be used to enhance the security of fixation and stability. Moreover, a more aggressive approach to prophylactic fixation before a catastrophic fracture develops has distinct advantages.