Denosumab is an antiresorptive agent that significantly reduces bone turnover markers, increases mineral density and as a result, decreases the risk of vertebral fractures. The drug holiday effect on denosumab is associated with a high risk of multiple vertebrae fractures soon after the withdrawal. Discontinuation reasons may vary, but common reasons are the patient's will, discontinuation due to an upcoming dental procedure and long treatment period. Treatment of these fractures can be either surgical augmentation or conservative with the use of antiresorptive drugs. The purpose of this scientific paper is to review current data on the effect of either kyphoplasty or vertebroplasty on these types of fractures. Several studies showed that surgical augmentation is associated with a higher risk of multiple vertebrae fractures in comparison with conservative treatment and thus, it is not recommended, though more research is needed.

the soft tissue damage around the fracture 1,[4][5][6][7] .Segmental fractures of long bones have a significant impact on various aspects of the patient's life. In some cases the fracture does not allow the patient to work and has financial consequences. Trauma limits the patient's normal social life and functionality. The burden of long bone fractures affects society through the loss of productivity, the direct and indirect costs of treatment, and the additional contribution to morbidity and mortality. The management and treatment of segmental fractures of long bones burdens health systems significantly due to

Background: Pathological fractures are a rising concern in the field of musculoskeletal oncology. Their incidence rises, mainly due to the improved diagnostic and therapeutic methods that lead to prolonged survival. The appropriate treatment has not been yet standardized, but the current bibliography describes surgical treatment capable of stabilizing the expected life expectancy. Orthopedic cement infusion in combination with broad abrasion of the bone metastasis has been described, although more research is needed.Case Report: A seventy-seven-year-old woman arrived at the emergency department with an ambulance, due to mentioned fall from her height, without being preceded by an episode of dizziness. Pain onset was sudden and there was inability of either standing or walking. Following the laboratory blood tests and the standard radiological tests (x-rays), a femoral diaphysis fracture with osteolysis of the femoral canal and a left-lung lobar consolidation. This patient was treated with broad abrasion of the bone metastasis, cement infusion, open reduction, internal fixation, and use of bone chips. Conclusion:Life expectancy in patients with bone metastases has been prolonged due to the evolution of chemotherapy, radiotherapy, and other oncological treatments. The broad abrasion of the bone metastasis and the filling of the bone gap with poly (methyl methacrylic acid) may give greater stability to the reduction of the fracture and reduce the risk of cancer cells spreading.