Fig. 3

Typical procedure for pathological fracture from malignant bone tumors. a Image data of A-P and lateral X ray films showed a metastatic neoplasm from primary renal carcinoma to distal femoral diaphysis before surgery. There was visible bone destruction at the displaced fracture ends. b Preoperative MRI imaging film demonstrated the soft tumor mass and hematoma surrounding the metastatic bone lesion. c Dissect the tumor-bearing bone from surrounding normal tissues with safe margin without piercing the hematoma around the displaced fracture ends. To make sure the hematoma was not broken, the vastus intermedius was retained in situ and would experience microwave ablation process together with the lesion, soft tumor mass, and hematoma. d The microwave generator and antenna were inserted into the tumor bulk and began to deliver electromagnetic energy into the tumor bulk. e Soft tumor mass was removed and fracture ends were exposed. f The mixture materials of autologous fibular graft with bone cement were used for filling defect space and the fracture was reduced and fixed through rigid steel plate. g Postoperative A-P X ray film showed the perfect reduction and reliable fixation