Introduction Multiple myeloma (MM) is a malignant tumor that causes widespread bone damage. The bone is involved in 90 % of MM patients, and 60% of patients develop pathologic fractures. Material and methods We report a case of combined surgical treatment and chemotherapy of a multiple myeloma patient who sustained a pathological diaphyseal fracture of the left femur and later presented with a lytic myeloma lesion in the right femur. Closed reduction and interlocking intramedullary (IM) nailing of the left femur was performed for the patient who was diagnosed with bone destruction in the shaft of the right femur a few months later. The right femur was fixed with interlocking IM nail for prophylaxis. Results The left femur consolidated at 6 months. The patient had no pain in the right femur, and enlargement in the bone destruction was not seen in the femur. The patient could ambulate with a cane with signs of deforming arthritis in the adjacent joints of the lower limbs. Discussion Three common surgical approaches used for bone tumors being complicated or not complicated by a pathologic fracture include nailing/plating, bone replacement and joint arthroplasty. Bone tumor replacement with oncological endoprostheses can be produced in specialized oncological orthopaedic units and is not available with regular trauma and orthopaedic services for different reasons. The operating orthopedic surgeon is to choose the appropriate implant to address the tumor involvement. Conclusion Interlocking IM nailing can be the method of choice for a pathologic fracture or for prophylactic bone fixation with appropriate indications identified with the Mirels's scoring system. Intramedullary nailing offers the advantage of minimally invasive stability for the operated limb and early weight-bearing in contrast to plate fixation treatment for fractures and prophylactic plating.

Long-term outcomes of reconstructive operations for substitution of post-resection defects of the articular ends of tubular bones that form the hip, knee and shoulder joints using home endoprosthesis were studied. The study included 344 patients who were treated at CITO department of bone pathology from 2004 to 2014. Substitution of the defect was performed in 236 and 108 cases for the knee, hip joints, respectively. Indications for surgical intervention were: bone tumors; previously performed arthroplasty failure; defects of the articular ends after failed traumatologic and orthopaedic operations; severe forms of knee arthroses. Functional results (MSTS scale), survival of constructions, inflammatory complications were analyzed and comparative evaluation with imported analogues was performed. General functional outcomes and rate of complications correspond to the data on application of new oncologic and modular endoprostheses presented in foreign literature.

Oncologic and orthopaedics results of surgical treatment of 32 patients with benign tumors of the thoracic and lumbar spine were analyzed. Tumors were manifested by the following nosologic forms: hemangioma, giant cell tumor, osteoid osteoma, osteoblastoma. Follow up period was from 2 to 16 years, at the time of results evaluation all patients were alive. It was shown that the following factors were responsible for the impairment of treatment results: late diagnosis, surgical treatment at nonspecialized clinics, widely spread tumor, severe neurologic disorders, spine deformity in the postoperative period.

Long-term outcomes of reconstructive operations for substitution of post-resection defects of the articular ends of tubular bones that form the hip, knee and shoulder joints using home endoprosthesis were studied. The study included 344 patients who were treated at CITO department of bone pathology from 2004 to 2014. Substitution of the defect was performed in 236 and 108 cases for the knee, hip joints, respectively. Indications for surgical intervention were: bone tumors; previously performed arthroplasty failure; defects of the articular ends after failed traumatologic and orthopaedic operations; severe forms of knee arthroses. Functional results (MSTS scale), survival of constructions, inflammatory complications were analyzed and comparative evaluation with imported analogues was performed. General functional outcomes and rate of complications correspond to the data on application of new oncologic and modular endoprostheses presented in foreign literature.