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| | eMedicine - Metastatic Carcinoma : Article by Howard A Chansky, MD |
 | | According to a 1995 publication by Hipp, current useful criteria are as follows: defect geometry affecting load-bearing capacity, the histologic cell causing the defect (ie, blastic, lytic, or mixed), and the anatomic site (femoral neck vs greater trochanter). |
 | | In the author's opinion, considering the use of the dynamic hip screw or plate for fixation of pathologic proximal femoral fractures is inappropriate because of the increased risk of already existing defects or the potential for additional metastatic defects in the femur distal to the initial lesion. |
 | | Defects of the ulna and radius, while rare, need to be fixed when almost any sized defect is discovered because these bones are subject to constant torsional loads, secondary to the pronation/supination actions of the forearm. |
| www.emedicine.com /orthoped/topic194.htm (5433 words) |
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