Intramedullary Nailing for Pathological Fractures of the Proximal Humerus.
BACKGROUND
Endoprosthetic reconstruction is widely applied for pathological fractures of the proximal humerus; however, functional impairment is usually unsatisfactory. The aims of the current study are to evaluate the reliability of interlocking intramedullary (IM) nailing with cement augmentation as a fixation method in proximal humeral lesions and to assess functional outcomes.


METHODS
We reviewed 32 patients with pathological fractures of the proximal humerus who underwent interlocking IM nailing and cement augmentation. Functional scores and pain relief were assessed as outcomes.


RESULTS
The mean follow-up period was 14.2 months. The mean Musculoskeletal Tumor Society functional score and Karnofsky performance status scale score were 27.7 and 75.6, respectively. Improvement of pain assessed using the visual analogue scale was 6.2 on average. Thirty-one patients (97%) experienced no pain after surgery. The mean ranges of forward flexion and abduction were 115° and 112.6°, respectively. All patients achieved stability and had no local recurrence without failure of fixation until the last follow-up.


CONCLUSIONS
Proximal interlocking IM nailing with cement augmentation appears to be a reliable treatment option for pathological or impending fractures of the proximal humerus in selected patients with metastatic tumors, even with extensive bone destruction.
['Choi|Eun-Seok|ES|', 'Han|Ilkyu|I|', 'Cho|Hwan Seong|HS|', 'Park|In Woong|IW|', 'Park|Jong Woong|JW|', 'Kim|Han-Soo|HS|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001859:Bone Neoplasms D005260:Female D005594:Fracture Fixation, Intramedullary D005598:Fractures, Spontaneous D006801:Humans D006810:Humeral Fractures D006811:Humerus D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D012189:Retrospective Studies
Pathologic fracture Humerus Intrameullary nailing Metastasis