Treatment of Pathological Fractures of the Humerus with a Locked Intramedullary Nail

Abstract

Retrograde insertion of the nail is associated with an increased risk of intra-operative fracture, and disease progression can occur, despite the administration of adjuvant therapy.

Treatment of pathological humeral shaft fractures with intramedullary nailing. A retrospective study

“…We agree with the idea that surgical treatment should be done in patients with at least six weeks of expected survival [1,15]. Cementation usually is performed to reconstruct large defects and enhance fixation [2,11] and is also used in radioresistent tumours [1]; however, Hunt et al found that fixation failure was not reduced. Also, by using advanced intramedullary implants, the use of PMMA at the site of the fracture is frequently unnecessary [9,11].…”

“…Radiation therapy by itself may weaken the underlying bone [10] and may not stop the progression of disease [2]. It should be applied in appropriate individuals [10].…”

“…Even though a retrograde approach has been associated with good results and has the advantage of not affecting elbow and shoulder function [13], it is not widely used because of the increased risk of iatrogenic fractures [2].…”

“…When fracture is present, non surgical management gives poor results [9], and internal fixation is recommended provided that the patient is medically fit for surgery [2]. The goals of surgical treatment are immediate reduction of pain by stabilising the fracture, return to mobility with full weightbearing as soon as possible, reducing morbidity, facilitation of nursing care and restoration of function of the affected extremity [2,9,10,11].…”

“…The goals of surgical treatment are immediate reduction of pain by stabilising the fracture, return to mobility with full weightbearing as soon as possible, reducing morbidity, facilitation of nursing care and restoration of function of the affected extremity [2,9,10,11].…”