Related Experiment Video
Updated: Dec 31, 2025
A Rat Tibial Growth Plate Injury Model to Characterize Repair Mechanisms and Evaluate Growth Plate Regeneration Strategies
Published on: July 4, 2017
Pathological fractures of humerus in children. Therapeutic and pathological considerations
Maria Daniela Trăilescu1, Adrian Ionel Pavel, Mircea Alexandru Pop
1Department of Anesthesia and Intensive Care, Department of Pediatrics, University of Medicine and Pharmacy of Craiova, Romania; mia.stoica69@gmail.com, singercristina@gmail.com.
Insights
This study shows that combining titanium elastic nails (TEN) osteosynthesis with bone substitution is an effective treatment for pathological humerus fractures in children caused by benign bone tumors, with no early complications or recurrence.
Area of Science:
- Pediatric Orthopedics
- Surgical Oncology
- Pathology
Background:
- Pathological fractures result from low-energy trauma in bones with altered histology, often preceded by pain.
- Common pediatric benign bone tumors causing these fractures include simple bone cysts, aneurysmal bone cysts, non-ossifying fibromas, and fibrous dysplasia.
- These tumors are typically asymptomatic until they fracture after minor trauma, with optimal treatment remaining debated.
Observation:
- A prospective study focused on surgically treated pediatric pathological humeral fractures.
- Three distinct cases of pathological humerus fractures in children were treated.
- Treatment involved curettage, histopathological examination, bone substitution, and titanium elastic nails (TEN) osteosynthesis.
Findings:
- No complications were observed in the early postoperative period.
- No recurrence of the condition was noted.
- The combined approach demonstrated successful outcomes in the treated cases.
Implications:
- Osteosynthesis with TEN and bone substitution offers a viable treatment for pathological humerus fractures secondary to benign bone tumors.
- This combined strategy effectively addresses the limitations associated with using isolated treatment techniques.
- The approach is suitable for surgically managed cases, irrespective of varying histopathological findings.
Introduction:
A pathological fracture appears after a low-energy trauma or minor trauma on bones with a modified histological structure; sometimes, the patient reports shoulder pain antedating the fracture. The most common benign bone tumors that cause pathological fractures in children are simple bone cysts, aneurysmal bone cysts, non-ossifying fibromas and fibrous dysplasia. This type of bone tumors is usually asymptomatic until they reach a large size and cause a pathological fracture after minor trauma. The optimal treatment remains controversial. Our objective was to describe our modern treatment strategies of the large benign osseous tumors of the humerus complicated by pathological humerus fractures and histological aspects in these cases.
Patients, Materials And Methods:
The study was prospective and included patients who were diagnosed with pathological humeral fractures, which required surgically orthopedic treatment. We selected three cases of pathological fractures of humerus in children each with its particularities, treated in the Department of Pediatric Surgery and Orthopedics, Emergency County Hospital, Arad, Romania. Treatment included curettage of the cyst, sampling for histopathological (HP) examination, bone substitution and titanium elastic nails (TEN) osteosynthesis.
Results:
No complications and no recurrence were seen in the early postoperative period.
Conclusions:
Osteosynthesis with TEN and bone substitution is a viable option for treatment of pathological fracture of humerus, secondary to the osseous benign tumors, which required surgically treatment, despite the different HP aspects. By using a combined treatment in these cases, we eliminate the disadvantages of isolated use of the described techniques in the literature.
More Related Videos
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:19Bones of the Upper Limb: Humerus
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:24Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
01:27Growth of Cartilage and Bone Tissue
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...