In a patient with known bone metastasis presenting with thigh pain, which fracture type is most likely?

• A. Compound fracture
• B. Pathologic fracture
• C. Greenstick fracture
• D. Transverse fracture

Answer: (B)

When bone is weakened by disease such as metastasis, a fracture can occur with little or no significant trauma. This is a pathologic fracture: a break that happens through bone that has been compromised by an underlying process. In someone with known bone metastases and thigh pain, the femur is a common site for such a fracture because the cancer lesions reduce the bone’s strength, making it susceptible to fracturing under normal weight-bearing or minor stress.

This concept helps distinguish it from other fracture types. A compound fracture is an open fracture with skin break, which isn’t implied by metastasis alone. A greenstick fracture is an incomplete break typical in kids when the bone is still relatively pliable. A transverse fracture is a clean break straight across the bone from a direct force and isn’t specifically tied to diseased bone. The presence of metastasis makes a pathologic fracture the most likely explanation for thigh pain and fracture risk. If suspected, prioritize immobilization and urgent imaging and evaluation.