MDCalc

Mirels’ Criteria for Prophylactic Fixation

Predicts risk of pathologic fracture in patients with long bone metastasis.

Use in patients with known long bone metastasis. Do not use if history of fracture or previous irradiation.

Site of lesion
Size of lesion
Nature of lesion
Pain

Result:

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Advice

In addition to Mirels’ Criteria, consider patient-specific factors such as comorbidities, predicted survival, other sites of disease, activity level, and bone mineral density when deciding whether or not to recommend prophylactic fixation.