Pathological Fractures: When Bones Break Without Injury- By Dr. Balaraju Naidu, Robotic Orthopedic Surgeon, ONUS Robotic Hospitals
A bone breaking without a significant fall or accident is not normal.
Fractures that occur during routine activities like walking, bending, or even turning in bed are a red flag and may indicate an underlying disease. These are known as pathological fractures.
Recognizing and treating the cause early can prevent repeated fractures, disability, and serious complications.
What Is a Pathological Fracture?
A pathological fracture occurs when a bone breaks because it has been weakened by disease, rather than by trauma.
In these cases, even minimal stress—such as standing, coughing, or lifting light objects—can cause a fracture.
Why Do Pathological Fractures Occur?
Healthy bones are strong and resilient. When bone structure is compromised by disease, it loses strength and becomes fragile.
Common Causes of Pathological Fractures
1. Osteoporosis
The most common cause. Loss of bone density makes bones thin and brittle, especially in the spine, hip, and wrist.
2. Bone Tumors and Metastasis
Cancers such as breast, prostate, lung, and multiple myeloma can spread to bones, weakening them significantly.
3. Chronic Bone Infections
Long-standing infections (osteomyelitis) erode bone structure, increasing fracture risk.
4. Vitamin D Deficiency
Leads to poor calcium absorption and weakened bones, especially in elderly patients.
5. Long-Term Steroid Use
Prolonged corticosteroid therapy reduces bone formation and increases bone breakdown.
Symptoms You Should Never Ignore
Seek medical evaluation if you notice:
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Persistent bone pain, especially at rest or night
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Fracture without injury or minimal trauma
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Sudden back pain with loss of height
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Recurrent fractures
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Difficulty walking or standing without a clear cause
These symptoms often point to underlying bone disease rather than simple injury.
How Are Pathological Fractures Diagnosed?
Diagnosis focuses on identifying both the fracture and its cause.
Investigations may include:
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X-rays
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MRI or CT scan
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Bone scans
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Blood tests (calcium, vitamin D, tumor markers)
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Bone density testing (DEXA scan)
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Biopsy, if a tumor is suspected
Treatment: Addressing the Fracture and the Cause
Management involves a two-step approach:
🔹 Stabilizing the Fracture
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Casting or bracing
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Surgical fixation (plates, rods, nails)
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Vertebroplasty or kyphoplasty for spinal fractures
🔹 Treating the Underlying Disease
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Osteoporosis medications
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Cancer therapy (chemotherapy, radiation, targeted therapy)
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Antibiotics for bone infection
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Vitamin D and calcium supplementation
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Adjusting long-term steroid therapy
Ignoring the root cause leads to repeat fractures and worsening disability.
Why Early Care Matters
Pathological fractures may be the first sign of serious conditions such as:
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Advanced osteoporosis
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Undiagnosed cancer
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Severe metabolic bone disease
Early diagnosis:
✔ Prevents repeat fractures
✔ Preserves mobility
✔ Improves quality of life
✔ Allows timely treatment of serious illnesses
Key Takeaway
📌 Bones should not break without injury.
📌 A fracture without trauma always needs evaluation.
If you or a loved one experiences unexplained fractures or persistent bone pain, seek orthopedic care immediately.
Early intervention can be life-changing—and life-saving.
For Appointments:
Dr. Balaraju Naidu, Robotic Orthopedic Surgeon
ONUS Robotic Hospitals – Hyderabad
👉 Button link: contact-us or book-appointment
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