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Clinical calculator summary

Mirels Score (Fracture Risk)

Mirels Score evaluates the risk of pathologic fracture in long bones with metastases.

Evidence-based context for fast calculator use

Purpose:
Mirels Score predicts pathologic fracture risk in metastatic long bone lesions to guide prophylactic surgical fixation versus radiotherapy.
Population:
patients undergoing skeletal metastasis stability, fracture-risk, survival, or operative assessment
Factors:
Site of Lesion, Pain Severity, Lesion Type, Size
Reference:
Mirels H. Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res. 1989;(249):256-264.
HomeMirels Score (Fracture Risk)
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Mirels Score (Fracture Risk)

Clinical Context & Background

Mirels Score evaluates the risk of pathologic fracture in long bones with metastases. It guides the decision between prophylactic surgical fixation versus radiotherapy alone.
Primary Source EvidenceMirels H. Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res. 1989;(249):256-264.
Formula Logic
Sum of points (1-3) for Site, Pain, Lesion Type, and Size.

Reference Data

Total ScoreFracture RiskRecommendation
≤ 7< 5%Radiotherapy / Observation
815%Borderline / Clinical Judgement
≥ 9> 33%Prophylactic Fixation Recommended

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use Mirels Score (Fracture Risk) when mirels Score predicts pathologic fracture risk in metastatic long bone lesions to guide prophylactic surgical fixation versus radiotherapy.
  • Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.

How To Interpret

  • Interpret the displayed result using the calculator-specific formula and reference table, spanning ≤ 7 through ≥ 9.
  • A boundary result should prompt input verification and clinical review rather than false precision.

What To Do Next

  • Combine the score with neurologic examination, mechanical pain, imaging, oncologic prognosis, radiosensitivity, surgical options, and patient goals.
  • Document the inputs, result, timing, and clinical context so the assessment can be reproduced.

Limitations

  • Fracture, spinal-instability, survival, and surgical-selection scores measure different domains and cannot substitute for urgent specialist assessment.
  • The result supports clinician judgment and does not independently determine treatment.

Validated Population

patients undergoing skeletal metastasis stability, fracture-risk, survival, or operative assessment

How to apply this result

For a representative case, verify Site of Lesion, Pain Severity, Lesion Type, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.

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Frequently Asked Questions

When should Mirels Score (Fracture Risk) be used?

Use it for patients undergoing skeletal metastasis stability, fracture-risk, survival, or operative assessment when all required inputs and the intended clinical setting are confirmed.

Can Mirels Score (Fracture Risk) determine treatment by itself?

No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.

Evidence-based oncology decision support. Verify with clinical guidelines.