Abstract

This paper reviews the current literature on metastatic lesions most likely to result in a pathologic fracture of a long bone. Prophylactic surgery is recommended in the following situations: Persisting or increasing local pain despite the completion of radiation therapy; permeative involvement; a solitary well-defined lytic lesion greater than 2.5 cm; a solitary well-defined lytic lesion circumferentially involving more than 50% of the cortex; metastatic involvement of the proximal femur associated with a fracture of the lesser trochanter.