'''Mirels' score''' is a tool useful in the management of bone tumors, by identifying those patients who would benefit from prophylactic fixation if they have a high enough risk of pathological fracture.
==Scoring==
A score of 1 to 3 is given for four criteria and summed together. A score greater than 8 suggests prophylactic internal fixation prior to irradiation.
{| class="wikitable" |- !rowspan="2"|Criteria<ref>{{cite journal |pmid=2684463 |year=1989 |last1=Mirels |first1=Hilton |title=Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures |journal=Clinical Orthopaedics and Related Research |volume=249 |issue=249 |pages=256–64 |doi=10.1097/00003086-198912000-00027}} Republished as: {{cite journal |doi=10.1097/01.blo.0000093045.56370.dd |pmid=14600587 |title=The Classic: Metastatic Disease in Long Bones a Proposed Scoring System for Diagnosing Impending Pathologic Fractures |journal=Clinical Orthopaedics and Related Research |volume=415 |issue=415 Suppl |pages=S4–13 |year=2003 |last1=Mirels |first1=Hilton |s2cid=43255503 }}</ref> !colspan="3"|Score |- | 1 | 2 | 3 |- | Site | Upper limb | Lower limb | Peritrochanteric |- | Pain | Mild | Moderate | Functional |- | Lesion | Blastic | Mixed | Lytic |- | Size | <{{frac|1|3}} | {{frac|1|3}}-{{frac|2|3}} | >{{frac|2|3}} |}
==References== {{reflist}}
==Further reading== *{{cite journal |doi=10.1302/0301-620X.94B10.30509 |pmid=23118375 |title=Metastatic disease around the hip: Maintaining quality of life |journal=Journal of Bone and Joint Surgery |volume=94 |issue=11 Suppl A |pages=22–5 |year=2012 |last1=Haidukewych |first1=G. J. }} *{{cite journal |doi=10.2217/ahe.09.30 |title=Management of long-bone metastases: A surgical perspective |journal=Aging Health |volume=5 |issue=3 |pages=313–21 |year=2009 |last1=Al-Ghamdi |first1=Ahmed |last2=Hings |first2=Ingrid |last3=Turcotte |first3=Robert E }} *{{cite journal |doi=10.1016/S0030-5898(05)70181-4 |pmid=11043102 |title=Metastatic Disease of the Femur |journal=Orthopedic Clinics of North America |volume=31 |issue=4 |pages=633–45 |year=2000 |last1=Ward |first1=William G. |last2=Spang |first2=Jeff |last3=Howe |first3=David }} *{{cite journal |doi=10.1159/000343556 |pmid=24917780 |pmc=4024504 |title=Tibial Metastasis from Muscle Invasive Bladder Carcinoma: An Unusual Site |journal=Current Urology |volume=7 |issue=3 |pages=160–2 |year=2013 |last1=Brennan |first1=David |last2=Kelly |first2=Michael E. |last3=Nason |first3=Gregory J. |last4=Collins-Smyth |first4=Coilin |last5=McGuire |first5=Barry B. |last6=Lennon |first6=Gerald M. }} *{{cite journal |doi=10.4103/0019-5413.143915 |pmid=25593359 |pmc=4292329 |title=Management of skeletal metastases: An orthopaedic surgeon′s guide |journal=Indian Journal of Orthopaedics |volume=49 |issue=1 |pages=83–100 |year=2015 |last1=Agarwal |first1=Manishg |last2=Nayak |first2=Prakash |doi-access=free }} *{{cite book |first1=Craig H. |last1=Gerrand |first2=Kenneth |last2=Rankin |year=2014 |chapter=Metastatic Disease in Long Bones. A Proposed Scoring System for Diagnosing Impending Pathologic Fractures |doi=10.1007/978-1-4471-5451-8_123 |chapter-url=https://books.google.com/books?id=cOu9BAAAQBAJ&pg=PA479 |editor1-first=Paul |editor1-last=Banaszkiewicz |editor2-first=Deiary F. |editor2-last=Kader |title=Classic Papers in Orthopaedics |pages=479–80 |isbn=978-1-4471-5450-1 }}
==External links== * [http://www.orthobullets.com/pathology/8002/impending-fracture-and-prophylactic-fixation Orthobullets]
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Category:Orthopedic clinical prediction rules