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needle biopsy of the distal femur.
11%
74/646
open reduction and internal fixation with a locking plate.
1%
6/646
closed reduction and fixation with a reamed antegrade locking intramedullary nail.
5/646
referral to an orthopaedic oncologist for staging studies, biopsy, and definitive management.
84%
545/646
IV antibiotics for 6 weeks.
9/646
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The radiograph shows a pathologic fracture through a destructive lesion of the distal femur metaphysis with osteolytic and osteoblastic features. The lateral cortex is destroyed, and there is periosteal new bone formation. These findings are consistent with malignancy, most likely an osteogenic sarcoma. Patients with suspected malignant tumors are best managed by surgeons with specific expertise in orthopaedic oncology. The biopsy of a malignant lesion should be deferred to the surgeon who is capable of definitive management of the patient.
4.2
(12)
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