Une fracture pertrochanterienne révélant un myélome multiple: quelle prise en charge?

Skeletal involvement is the major clinical complication of multiple myelomas, resulting in pathological fractures. Proximal femoral fractures are very frequent during multiple myeloma evolution and they seriously compromise survival and quality of life of patients with cancer. Early surgical treatment allows mortality and morbidity improvement. Cervicomedullary Gamma locking nail osteosynthesis allows efficient, sustainable and stable fixation associated with early patient mobilization and survival improvement. However, prolonged survival imposes regular monitoring of the osteosynthesis in order to detect and to treat equipment failure. We should not overlook the fact that the recovery of independence after pertrochanterian fracture also influences myeloma control through the possibility to perform bone marrow autograft or not.