Extended Applications of Trauma Implants to Prevent or Treat Fractures in Pathological Bone

Abstract In this chapter, the authors explore the implications of trauma implants for fractures occurring in pathological bone. The focus of the management of pediatric pathological fractures has shifted from treatment to prevention. Common pediatric problems include but are not limited to osteogenesis imperfecta (OI), fibrous dysplasia, pseudoarthrosis (tibial shaft and femoral neck), and tumors (benign and malignant). It becomes challenging to use even a familiar implant in a compromised pediatric bone. Moreover, implants are used whenever it is immensely important to avoid iatrogenic fracture and growth-related complications or when the goal of the surgery itself is to prevent fracture and/or deformity correction. Implants like Fassier–Duval (FD) nail, EVOS plate, mega-prosthesis, and titanium elastic intramedullary nail system (TENS) require special consideration when used in a biologically weak bone. This chapter provides unique insight into such unconventional usage of trauma implants to prevent or treat fractures in the pathological bone.