Overview of surgical options for fixation and reconstruction of pathologic fractures of the lower extremity according to anatomic site

Site of fracture	Common practice	Controversies and considerations
Femoral neck	Hemiarthroplasty	Standard versus long-stem Cemented versus non-cemented
Intertrochanteric/subtrochanteric	Reconstruction nail versus hemiarthroplasty	ORIF versus endoprosthetic replacement hemiarthroplasty Standard versus cementless calcar-replacement hemiarthroplasty versus proximal femoral replacement
Femoral diaphysis	Reconstruction nail	Closed versus open with curettage Cemented versus non-cemented
Distal femur	Reconstruction nail versus retrograde nail versus locked plate/screws versus combination	Unusual location Cemented versus non-cemented Distal femoral replacement for advanced destruction
Proximal tibia	Plate versus antegrade tibial nail versus combination	Unusual location Cemented versus non-cemented Proximal tibial replacement for advanced destruction
Tibial diaphysis	Antegrade tibial nail	Closed versus open with curettage Cemented versus non-cemented
Acetabulum	Total hip with protrusio cage versus curettage/cement	Arthroplasty versus curettage/cementing

ORIF: open reduction internal fixation.

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