Ante-grade intramedullary nailing for the treatment of humeral shaft metastatic bone tumor

Abstract

Background: The surgical treatment of humeral fractures is controversial, and conservative therapy of pathologic fractures is not recommended. Materials and Methods: We performed a retrospective study of eight patients who had pathological humeral shaft fractures. All fractures were stabilized with ante-grade intramedullary nailing and wide resection of the tumor. Bone defects were filled with polymethylmethacrylate cement augmentation. Results: The mean operative time for the procedure was 160 min (range, 120-190 min), and the mean duration of hospitalization was 10.5 days (range, 5-15 days). Relief of pain was rated as good to excellent. There were no wound problems, deep infections, nerve palsies, or implant failures observed. X-ray studies demonstrated the improved stability of the humerus. Conclusion: Interlocking intramedullary nailing for pathological humeral shaft fractures provides immediate stability and can be accomplished with wide resection of tumor and bone defect augmentation with cement. Early return of functional status and pain relief greatly improved the patient's quality of life.