[Surgical treatment of metastases of the humerus]

Surgical treatment of metastasis disease of the humerus was applied for 46 lesions among 42 patients, i-e 22% of overall osteosyntheses for skeletal metastasis. Two patients only are still alive at 3 and 4 years. The mean survival time is 8.1 months and at 3 months 50% died. Metastasis disease of the humerus becomes evident late during the evolution of the primary cancer, but 26% are revealing lesions. For 9.5% the primary tumor remains unknown. After review of the surgical methods generally used, indirect osteosynthesis by intra-medullary pinning according to Hackethal, without bone cement, is alleged. So the arm is immediately mobilized and a complementary irradiation is applied in post-operative. Prophylactic fixation of impending fractures is encouraged in order to suppress pain, and for better function. This paper demonstrates the changing concept of internal fixation of pathologic fractures and recommends intra-medullary nailing or pinning.