cliot (version 1.0.0)

mirels_fracture_score: Mirels' Criteria for Prophylactic Fixation

Description

Calculates the Mirels' Score to assess the risk of pathological fracture in long bones due to metastatic disease. The score evaluates four parameters: site, pain, lesion type, and lesion size. It helps determine whether prophylactic surgical fixation or radiotherapy is the appropriate management strategy.

Usage

mirels_fracture_score(site, pain, lesion_type, size_ratio)

Value

A list containing:

Mirels_Score

The calculated total score (Range 4-12).

Recommendation

Clinical guidance based on the score threshold (Fixation indicated for score >= 9).

Est_Fracture_Risk

Estimated risk of pathological fracture.

Arguments

site

String. Location of the lesion. "upper_limb": Upper extremity (1 pt). "lower_limb": Lower extremity (2 pts). "peritrochanteric": Peritrochanteric region (3 pts).

pain

String. Severity of pain. "mild": Mild pain (1 pt). "moderate": Moderate pain (2 pts). "functional": Functional/Severe pain (3 pts).

lesion_type

String. Radiographic appearance of the lesion. "blastic": Blastic (1 pt). "mixed": Mixed (2 pts). "lytic": Lytic (3 pts).

size_ratio

String. Size of the lesion relative to the bone diameter. "lt_one_third": < 1/3 of bone diameter (1 pt). "one_third_to_two_thirds": 1/3 - 2/3 of bone diameter (2 pts). "gt_two_thirds": > 2/3 of bone diameter (3 pts).

References

Mirels H. Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res. 1989;(249):256-264.

Examples

# Example 1: High Risk
# Peritrochanteric (3), Functional pain (3), Lytic (3), >2/3 size (3)
# Score = 12
mirels_fracture_score("peritrochanteric", "functional", "lytic", "gt_two_thirds")

# Example 2: Low Risk
# Upper limb (1), Mild pain (1), Blastic (1), <1/3 size (1)
# Score = 4
mirels_fracture_score("upper_limb", "mild", "blastic", "lt_one_third")