Pathological fractures occur when medical conditions weaken bones to the point where they break spontaneously. Osteoporosis is a common cause, and treatment aims to prevent further bone loss and relieve pain. Other conditions, such as osteomalacia and bone tumors, can also increase the risk of pathological fractures. Healing may take longer than normal fractures.
Human bone is remarkably strong and can often withstand significant trauma without breaking. However, many medical conditions can weaken bones to the point where they are unable to even adequately support body weight. When this happens, normally hard bones can fracture spontaneously. The resulting break is called a pathological fracture.
A pathological fracture is almost always a sign of a serious underlying medical problem. Conditions that have progressed enough to affect the thickness or shape of the bone are usually very difficult to treat. In many patients, especially in older women, osteoporosis is to blame.
Throughout a person’s life, his bones grow and are simultaneously reabsorbed by the body. In healthy individuals, these dual processes occur at approximately the same rate. Osteoporosis occurs when the absorption of minerals in the bones far exceeds the ability of the bones to regenerate.
When osteoporosis has weakened the bones enough to cause a pathological fracture, treatment options are usually limited. Bisphosphonates can help strengthen bones to some extent, but a complete reversal of bone density loss is highly unlikely. More often than not, the goal of osteoporosis treatment is to prevent further bone loss and relieve pain. Special care is taken to prevent injury from falls and other situations that could increase the risk of further bone fractures.
Ostomalacia also results from an imbalance in the rate of bone growth and resorption, but this condition primarily affects bone growth. Unlike the brittle bones created by osteoporosis, the bones of an osteomalacia patient can become so soft that they bend. Pressure on the ends of these bones can result in a pathological fracture of the arch of the arch. Regardless of the underlying cause of osteomalacia, lack of vitamin D is always the direct cause of bone damage. Supplements of the vitamin may prevent further injury, but they won’t fix the damage that has already occurred.
Any change in the shape or density of a bone, including those caused by bone tumors, can increase the chance of a pathological fracture. Thus, both benign and malignant bone tumors have been responsible for spontaneous bone fractures. Unlike malignant tumors, however, benign bone tumors generally do not cause a reduction in bone density and, therefore, are much less likely to weaken bones.
A pathological fracture can take longer to heal than normal fractures. The same conditions that caused bones to weaken often also affect natural bone rebuilding. Physical therapy is often prescribed with the hope that increasing muscle strength in the affected area will help relieve the load on the bone.
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