Recent advances in the treatment of pathological fractures.

Pathological fractures present challenging and difficult management problems. Conservative treatment frequently results in non-union, while open reduction and internal fixation usually involves prolonged immobilization and bed rest with attendant medical complications. The use of methylmethacrylate as an adjunct to conventional forms of internal fixation represents a recent advance in the management of unstable, pathological fractures. The hospital stay can be markedly shortened and the patient's functional capacity increased relatively early in the postoperative period. This paper reports the results of this approach to therapy in a series of over 75 patients, and outlines indications and timing of this procedure before pathological fractures occur in instances where early diagnosis of bone malignancy has been made.