Pathologic fractures in primary bone tumors: a paradigm shift in management

Pathologic fractures in primary bone tumors have long been seen as a major clinical challenge. They complicate diagnosis, staging, and treatment. Historically, these fractures, especially in malignant lesions, were seen as a sign of poor prognosis due to higher risks for local recurrence and mortality. Recently, however, literature and practice show a paradigm shift. With advances in neoadjuvant therapies, surgical techniques, and targeted agents, our clinical approach has evolved. As a result, prognosis has improved for many patients, and limb salvage has become a more realistic option. Pathological fractures are common in benign