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Review
. 2025 Mar 13;17(6):973.
doi: 10.3390/cancers17060973.

Advancements in Assessing Pathological Fracture Risk: News on Mirels' Score

Cesare Meschini  1 , Alessandro El Motassime  1   2 , Omar El Ezzo  2 , Antonio Ziranu  3   4 , Giulio Maccauro  1   2 , Raffaele Vitiello  1   2
Affiliations
Review

Advancements in Assessing Pathological Fracture Risk: News on Mirels' Score

Cesare Meschini et al. Cancers (Basel). .

Abstract

The Mirels' score is a widely utilized tool for assessing the risk of pathological fractures in patients with metastatic bone disease. This scoring system assists clinicians in estimating fracture likelihood based on clinical, radiological, and anatomical parameters, thereby guiding treatment decisions and management strategies. This review provides a comprehensive analysis of the Mirels' score, detailing its development, clinical applications, and its role in predicting fractures across various metastatic cancers. Additionally, it discusses the score's limitations, including its potential to over- or underestimate fracture risk, and explores recent advancements in imaging and biomarker technologies that may enhance or complement its predictive accuracy. By critically examining the existing literature, this review aims to offer a thorough understanding of the Mirels' score's strengths and weaknesses, while considering its future role in personalized cancer care.

Keywords: Mirels’; femur fracture; impending; oncologic; pathologic; score.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Pesare E., Meschini C., Caredda M., Messina F., Rovere G., Solarino G., Ziranu A. Carbon vs. Titanium Nails in the Treatment of Impending and Pathological Fractures: A Literature Review. J. Clin. Med. 2024;13:2940. doi: 10.3390/jcm13102940. - DOI - PMC - PubMed
    1. El Motassime A., Meschini C., Di Costa D., Rovere G., Matrangolo M.R., De Maio F., Farsetti P., Ziranu A., Maccauro G., Vitiello R. Functional Outcomes and Shoulder Instability in Reconstruction of Proximal Humerus Metastases. Curr. Oncol. 2023;30:3571–3579. doi: 10.3390/curroncol30040272. - DOI - PMC - PubMed
    1. Ghimire S., Miramini S., Edwards G., Rotne R., Xu J., Ebeling P., Zhang L. The investigation of bone fracture healing under intramembranous and endochondral ossification. Bone Rep. 2020;14:100740. doi: 10.1016/j.bonr.2020.100740. - DOI - PMC - PubMed
    1. Kong A.C., Zarate S.D., Belzarena A.C. Missed pathological femoral neck fracture undergoes spontaneous healing. Radiol. Case Rep. 2021;17:72–76. doi: 10.1016/j.radcr.2021.10.002. Erratum in Radiol. Case Rep. 2023, 18, 1387–1388. https://doi.org/10.1016/j.radcr.2022.10.050 . - DOI - PMC - PubMed
    1. Verspoor F.G.M., Hannink G., Parry M., Jeys L., Stevenson J.D. The Importance of Awaiting Biopsy Results in Solitary Pathological Proximal Femoral Fractures: Do We Need to Biopsy Solitary Pathological Fractures? Ann. Surg. Oncol. 2023;30:7882–7891. doi: 10.1245/s10434-023-13931-4. - DOI - PMC - PubMed

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