A and B, Anteroposterior and lateral radiographs of proximal femur of 82-year-old man with metastatic kidney cancer reveal multiple lytic lesions. Patient failed to respond to radiation. Prophylactic internal fixation was scheduled; however, operation was canceled because the patient was considered medically unstable for surgery. C, Anteroposterior view of left hip of same patient several weeks later after sustaining pathologic fracture. Surgery is now more difficult, and patient has experienced greater morbidity.