Tratamento de fraturas patológicas tumorais diafisárias do úmero com haste intramedular rígida bloqueada estática – Experiência de 22 anos

Abstract

ObjectiveRetrospective observational study in patients submitted to fixation with intramedullary nail after established or impeding pathological humerus‐shaft tumoral fracture in the context of disseminated tumoral disease alongside 22 years experience in the same institution. MethodsSample with 82 patients and 86 humeral fixations with un‐reamed rigid interlocking static anterograde or retrograde intramedullary nail. ResultsThe most prevalent primary tumors were breast carcinoma (30.49%), multiple myeloma (24.39%), lung adenocarcinoma (8.54%), and renal cell carcinoma (6.10%). The average nailing operation time was 90.16 ± 42.98minutes (40‐135). All patients referred arm pain improvement and there was a MSTS mean score rise from 26% in the preoperative to 72.6% in the evaluation performed in the still living patients three months after the surgery. The survival rate showed an overall survival of 69.50% at three months after surgery, 56.10% at six months, 26.70% at one year, and 11.90% at two years. None of the deaths were related to the surgery or its complications. There were only four complications related to the operation, one intraoperative and three late, corresponding to a 4.65% complications risk. ConclusionClosed un‐reamed static interlocking intramedullary nailing (anterograde or retrograde) of the humerus is a fast, safe, effective, and low morbidity procedure in the treatment of pathological fractures of humerus shaft, guaranteeing a stable arm fixation and consequently improving function and life quality of these patients during their short life expectation.