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Pathologic fractures of the humerus.

J M Lancaster1, L A Koman, A G Gristina

  • 1Department of Surgery, Bowman Gray School of Medicine, Wake Forest University Medical Center, Winston-Salem, NC 27103.

Southern Medical Journal
|January 1, 1988
PubMed
Summary
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Rigid internal fixation, methylmethacrylate, and radiation therapy offer significant benefits for patients with pathologic humerus fractures. This approach improves pain relief and extremity function in cancer patients with a survival of six weeks or more.

Area of Science:

  • Orthopedic Surgery
  • Oncology
  • Medical Device Engineering

Background:

  • Pathologic fractures of the humerus in patients with inoperable cancer present significant challenges for pain management and functional preservation.
  • Previous treatment modalities have shown variable success rates in addressing these complex cases.

Purpose of the Study:

  • To retrospectively analyze and compare the effectiveness of various treatments for pathologic humerus fractures in patients with inoperable cancer.
  • To evaluate functional outcomes and pain relief achieved with different surgical and non-surgical interventions.

Main Methods:

  • Retrospective chart review of 57 pathologic humerus fractures in 52 patients treated between 1972 and 1982.
  • Categorization of treatments including nonoperative management, intramedullary fixation (Rush, Küntscher, Ender rods), and endoprosthetic replacement.

Related Experiment Videos

  • Assessment of functional results and pain relief using a modified Perez rating system.

    • Main Results:

    • Nonoperative treatment yielded poor functional results and fair pain relief.
    • Intramedullary fixation and endoprosthetic devices were employed in 50 fractures.
    • Operative complications occurred in seven patients, with intramedullary rod prominence being the most frequent (n=3).

    Conclusions:

    • Rigid internal fixation with appropriate devices, supplemented by methylmethacrylate and localized postoperative irradiation, is recommended for patients with pathologic humerus fractures and a predicted survival of at least six weeks.
    • This combined therapeutic approach is likely to enhance both pain control and extremity function.