Pathological fracture risk (Harrington criteria)

Changed by Henry Knipe, 1 Nov 2015

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Harrington criteria can be used to predict which skeletal metastases are at high risk of pathological fracture and should undergo prophylactic internal fixation. It preceded Mirel classification for impending pathological fracture but has not been validated and its use is debated.

Classification

>50% cortical bone destruction
lesion >2.5 in size
pathological avulsion fracture of the lesser trochanter
function pain after radiation therapy

-<p><strong>Harrington criteria</strong> can be used to predict which <a title="Skeletal metastases" href="/articles/skeletal-metastases">skeletal metastases</a> are at high risk of <a title="Pathological fracture" href="/articles/pathological-fracture">pathological fracture</a> and should undergo prophylactic internal fixation. It preceded <a title="Pathological fracture risk: Mirel classification" href="/articles/pathological-fracture-risk-mirel-classification">Mirel classification</a> for impending pathological fracture but has not been validated and its use is debated. </p><h4>Classification</h4><ul>
+<p><strong>Harrington criteria</strong> can be used to predict which <a href="/articles/skeletal-metastases">skeletal metastases</a> are at high risk of <a href="/articles/pathological-fracture">pathological fracture</a> and should undergo prophylactic internal fixation. It preceded <a href="/articles/pathological-fracture-risk-mirel-classification">Mirel classification</a> for impending pathological fracture but has not been validated and its use is debated. </p><h4>Classification</h4><ul>

References changed:

1. Piccioli A, Spinelli MS, Maccauro G. Impending fracture: A difficult diagnosis. (2014) Injury. 45 Suppl 6: S138-41. <a href="https://doi.org/10.1016/j.injury.2014.10.038">doi:10.1016/j.injury.2014.10.038</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/25457334">Pubmed</a> <span class="ref_v4"></span>
2. Browner BD, Jupiter JB, Krettek C et-al. Skeletal Trauma: Expert Consult (Browner, Skeletal Trauma). Saunders. ISBN:B00QT83ORI. <a href="http://books.google.com/books?vid=ISBNB00QT83ORI">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/B00QT83ORI">Find it at Amazon</a><span class="auto"></span>
3. Intramedullary Nailing: A Comprehensive Guide. Springer. ISBN:B00S5XKUGI. <a href="http://books.google.com/books?vid=ISBNB00S5XKUGI">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/B00S5XKUGI">Find it at Amazon</a><span class="auto"></span>

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