1. The advantages of managing malignant pathological fractures in long bones by operative internal fixation is recognized. When conventional fixation is used, failures have resulted because of extensive cortical bone lysis about the fracture site with consequent instability.
2. Thirty-one actual and two incipient malignant pathological fractures in thirty patients were managed by internal fixation augmented by replacement of locally resected tumor and pathological bone by methylmethacrylate.
3. This method achieves immediate solid fracture immobilization with consequent alleviation of pain, early active joint motion, and early weight-bearing with minimum, if any, support.
4. True fracture healing probably does not occur. However, in only one patient did failure of fixation result.