Pathologic Hip Fractures in the Geriatric Patient

Pathologic hip fractures affect a unique subset of patients in the growing geriatric population. Geriatric and cancer populations require multidisciplinary care, and this intersection of patient profiles requires a unique combination of medical, orthopedic, and oncologic expertise. Treating these fractures not only requires a robust diagnostic process of laboratory, imaging, and histologic testing, but also may require complex coordination of surgical, medical, and radiation therapies. The question of whether, and how, to operate on a pathologic hip fracture often requires difficult decisions about a patient’s cancer status, expected longevity, and goals of care. Ultimately, while the goals of the treatment of pathologic fractures are the same as any other fracture – pain relief and early mobilization – the treatment of pathologic fractures can differ significantly from an otherwise identical fracture in a non-pathologic setting. With a growing geriatric population and advances in systemic therapies progressively increasing the life expectancy of those with metastatic cancer, the incidence of pathologic fractures continues to rise. All orthopedic surgeons must be familiar with the basic principles of diagnosis and appropriate treatment of these fractures.