Abstract
A 58-yr-old woman with a malignant tumor of the renal pelvic and ureter was scheduled for a nephroureterectomy at the flexed lateral position. Preoperatively her general condition was good except for right shoulder pain. The operative course was uneventful during anesthesia. On the first operative day she began to complain of severe pain on the right shoulder and the claviclar portion. Roentgenogram revealed a fracture of her right clavicle. In the preoperative chest X-rays, osteolytic metastasis on the right clavicle was present. Consequently, we diagnosed this case as a pathological fracture. Extreme care must be taken with anesthetized patients, who require position change during surgery in order to minimize the incidence of trauma to pathological bones.
