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KMID : 0613320030090010001
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Journal of the Korean Bone and Joint Tumor Soceity
2003 Volume.9 No. 1 p.1 ~ p.11
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Clinical Interlocking Intrmedullary Nailing of Metastatic Diaphyseal Fractures of the Humerus
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Park Won-Jong
Rhee Seung-Koo
Kang Yong-Koo
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Abstract
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Purpose : To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing.
Materials and Methods : Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients(16 cases) treated with closed intrameduallry interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al.
Results : Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery.
Conclusion : Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intrameduallry nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.
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KEYWORD
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Diaphysis of humeurs, Pathologic fracture, Closed interlocking intrameduallry nailing
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