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Pathologic fracture of the humerus.

J E Flemming, R K Beals

    Clinical Orthopaedics and Related Research
    |February 1, 1986
    PubMed
    Summary

    Pathologic fractures of the humerus, often caused by breast cancer, frequently fail to heal with closed treatment. Operative management is generally superior to nonoperative methods for these challenging fractures.

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    Area of Science:

    • Orthopedic Surgery
    • Oncology
    • Medical Research

    Background:

    • Pathologic fractures of the humerus are often associated with poor outcomes when treated nonoperatively.
    • Breast cancer is the most frequent cause of pathologic humeral fractures.

    Purpose of the Study:

    • To evaluate the effectiveness of different treatment modalities for pathologic fractures of the humerus.
    • To determine the incidence of humeral metastases in patients with persistent breast cancer.

    Main Methods:

    • Retrospective review of 103 patients with persistent breast cancer.
    • Analysis of treatment outcomes for patients with pathologic humeral fractures.

    Main Results:

    • Closed treatment of humeral pathologic fractures led to high rates of pain, disability, and nonunion.
    • Humeral metastases were found in 18.5% of patients with persistent breast cancer.
    • Operative treatment demonstrated superior outcomes compared to nonoperative management for these fractures.

    Conclusions:

    • Nonoperative management of pathologic humeral fractures is associated with significant morbidity.
    • Operative intervention is generally the preferred approach for managing pathologic fractures of the humerus.
    • Prophylactic internal fixation for humeral metastases is not routinely indicated.

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