Approach to Pathologic Fractures in Children

Amy K. Williams; Alexandre Arkader


Curr Orthop Pract. 2013;24(3):260-266. 

In This Article


Enchondromas are benign cartilaginous tumors that are centrally located and lead to cortical thinning. They often present with a pathologic fracture, particularly when the lesions are located in the small tubular bones of the hands and feet.[8,28] The most common sites of involvement in decreasing order of frequency are the phalanges, metacarpals, metatarsals, humerus, and femur.[1]

Multiple enchondromas may be part of Ollier or Maffucci syndrome and associated with a fracture incidence of up to 30%.[29] Pathologic fractures usually are treated conservatively, and the lesion is treated at a second stage. Currettage and bone-grafting are recommended if the lesion is painful or if there is an impending or recurrent pathologic fracture.