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What Is a Pathologic Fracture?

Medically Reviewed by Dan Brennan, MD on April 15, 2021

If you have a chronic health condition, it may have negative effects on the density of your bones. With weak bones, there's a higher chance that fractures can happen, even without any impact to your bones. What does it mean when you break a bone without any known cause for the break?

Understanding Pathologic Fractures

A fracture is a break in your bone. A break is called a pathologic fracture when force or impact didn’t cause the break to happen. Instead, an underlying disease leaves your bones weak and brittle. You may move wrong or shift your body weight in a way that puts pressure on weak bones.

For most people, it takes a significant force to break your bones. You can fall without sustaining a break. But weak bones may not tolerate as much pressure, buckling under body weight or minor trauma. Unfortunately, many health conditions lead to bone deterioration.

Two common health conditions include:‌

  • Tumors – If tumors grow near your bones or originate from your bones, they can cause pathologic fractures. The added pressure of tumors placing weight on your bones may be too much.
  • Osteoporosis – This condition occurs primarily in older adulthood. If you don’t get enough calcium and vitamin D in your diet to support bone density, you lose it. Pathologic fractures are frequently caused by osteoporosis.

You may have osteoporosis if you’ve shrunk more than one inch from your height as a young adult. Osteoporosis chips away at your bone density. Your bones may settle or collapse, causing you fractures to happen even if you’re being careful.

Other conditions that may lead to pathologic bone fractures include: 

  • Cerebral palsy
  • Muscular dystrophy‌
  • Spinal muscular atrophy
  • Spinal Muscular Atrophy 
  • ‌Spina bifida
  • Down syndrome
  • ‌Endocrine conditions like hyperthyroidism or hyperparathyroidism
  • Cystic fibrosis
  • Renal disease
  • Cholestatic liver disease
  • Celiac disease
  • Inflammatory bowel disease
  • Rheumatoid arthritis
  • Other rare genetic conditions‌

Risk of Pathologic Fractures

While you can take steps to strengthen your bones when you’re young, you can’t predict if you’ll get a pathologic fracture. Factors that increase your risk include:

  • Not getting enough nutrients in your diet, specifically vitamin D and calcium as well as protein
  • Being underweight or overweight
  • Pain in your bones or back
  • Lack of physical activity and mobility
  • Too little time in the sun to absorb vitamin D
  • Sex or growth hormone disruptions
  • Increase in inflammatory conditions‌
  • History of pathologic fractures in your family

Treatments for Pathologic Fractures

You can’t reverse bone damage, but you can slow it down. Talk to your doctor about your symptoms and how they impact your quality of life. After determining the severity of your condition, your doctor can put together a treatment plan. The goals of treatment are pain relief, reversal or stabilization of neurological deficits, and stabilization of the spine.

Avoiding surgery for fractures is recommended, especially for very brittle bones. Instead, your doctor may:

  • Prescribe pain medication to keep you comfortable
  • Limit your physical activity until the pathologic fracture heals completely
  • Put you in a back or leg brace for stability and to remove pressure from the affected area

Impact of Pathologic Fractures on Your Health

A pathologic fracture can leave you with permanent damage. You can lessen the impact a pathological fracture has on your health by:

  • Not carrying things that are too heavy and asking for help instead
  • Getting durable bone implants that allow you to keep using that part of your body with less stress to the area
  • Practicing balance and stability for shifting how you bear your weight

When you fracture a bone, it leaves you with less mobility. Pain from a pathologic fracture may make you feel nervous about getting hurt again, but it is important to stay active. This is especially important as you age because staying active helps maintain your cardiovascular health. When you're already dealing with a pathologic fracture, you don't need the burden of another health condition. 

Pathologic fractures may impact your health in other ways, too. If fractures go untreated, they may cause swelling, bruising, and pain. In some cases, they lead to skeletal deformities or changes in how you are able to sit, stand, or sleep. The constant pain of a pathologic fracture may also leave you irritable and disinterested in things you used to enjoy doing. 

WebMD Medical Reference

Sources

SOURCES:

Columbia Neurological Surgery: “Pathologic Fracture.”

Johns Hopkins Medicine: "Sitting Disease: How a Sedentary Lifestyle Affects Heart Health."

Journal of Pharmacy and Therapeutics: “Osteoporosis: A Review of Treatment Options."

Medical Home Portal: “Osteoporosis and Pathologic Fractures.”

National Library of Medicine: “StatPearls: Pathologic Fractures.”

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