Pathological Fracture Caused by Bone Metastasis of Rectal Cancer Misdiagnosed as a Common Fracture and Treated With Open Reduction and Internal Fixation: A Case Report

Abstract Background: Pathologic fractures following bone metastasis of rectal cancer are relatively uncommon. Case presentation: A 59-year-old male rectal cancer patient in China with bone metastases in the right femur that caused a right femoral pathological fracture. According to emission computed tomography (ECT) and other examinations, and with the assistance of a multidisciplinary team, bone metastasis was diagnosed. Because the traumatic orthopedic surgeons did not notice his history of colorectal cancer preoperatively, there was no diagnosis of pathological fracture, and open reduction and internal fixation were performed. Additionally, there was no postoperative radiotherapy to the area or systemic treatment. Multiple re-examinations of the patient within 4 months after surgery revealed that the fracture did not heal. The patient was readmitted and treated 9 months after open reduction and internal fixation, and the tumor gradually spread in the proximal right femur.Conclusions: The combination of a medical history, preoperative ECT examination, local DR examination, CT examination and MRI examination are necessary for a preoperative diagnosis. This case report mainly recorded the whole treatment and follow-up process.