radiotherapy
Management
Mirels Prediction system for Pathological Fracture
Clin Orthop 1989
- 38 patients treated with DXRT without surgery
- most breast cancer
- developed scoring system
- predicts post DXRT fracture risk in preDXRT long bones
- risk of fracture within 6 months
- irradiated without fixation
Four risk factors
Heterotopic Ossification
Definition![HO Brooker 4](/sites/default/files/TDwyer/THR Brooker 3%3A4.jpg)
Extraskeletal bone formation in periarticular tissues
- HA crystals within osteoid matrix
Different to calcification
- osteoid matrix laid down
Types
1. Myositis Ossificans
- post traumatic
Spinal Metastasis
Epidemiology![Thoracic Metastasis](/sites/default/files/Spine/Spine Mets.jpg)
80% cancer patients have spinal metastasis at autopsy
Spine is number one site for bony metastasis (50%)
Cause
Hexagon: PBBLTK
Prostate Breast