Surgical Treatment of Pathologic Humeral Fracture

PURPOSE: To evaluate and analyze the radiographic and clinical outcomes after the surgical treatments of pathologic humeral fractures. MATERIALS AND METHODS: From October 1993 to September 2007, a retrospective investigation was conducted with a total of 13 patients who underwent operations for pathologic humeral fractures. The methods of surgical treatment were as follows-four cases of open reduction and internal fixation; eight cases of closed reduction and internal fixation with intramedullary nailing; and one of radical excision and hemiarthroplasty. RESULTS: Of nine patients with metastatic bone lesions, three were diagnosed with primary cancer after the incidence of pathologic humeral fracture. The mean period between the diagnosis of primary cancer and pathologic fracture in the latter six cases was 36.7 (2~144) months and the mean survival period after the surgical treatments was 22.8 (12~35) weeks in all patients with bone metastasis. Fracture unions were noted in all four cases of primary humeral bone lesion but none in metastatic cases. Pain relief and functional recovery were noted in eleven patients of this study. CONCLUSION: Satisfactory clinical outcomes with sustained pain relief and functional recovery were observed after the surgical treatments of pathologic humeral fracture. Benign bone lesions require more active and early treatments in order to facilitate the functional recovery of upper extremities and fracture union. With pathologic humeral fractures originated from metastasis, palliative treatments were preferred to fracture union method for planning long-term pain relief and functional recovery.

The Mid to Long Term Results of PCL Substitution Type Total Knee Arthroplasty with Using a Scorpio(R) system (Comparison with or without Patella Resurfacing)

PURPOSE: The purposes of this study were to evaluate the clinical results of performing total knee arthroplasty (TKA) with using the posterior substitution (PS) type Scorpio(R) system and to compare the clinical results of the patellar resurfacing group with those of the patellar non-resurfacing group. MATERIALS AND METHODS: 72 TKAs in 51 patients with minimum 7 years' follow-up were evaluated in terms of flexion contracture, the range of motion, the Hospital for Specific Surgery (HSS) knee score and the radiologic findings. We compared the clinical results of 42 cases in 31 patients with patellar resurfacing with those of 30 cases in 20 patients without patellar resurfacing. RESULTS: Flexion contracture, the range of motion and the HSS knee scores were significantly improved after the TKAs. Radiolucencies were found in 14% of the cases on the anteroposterior views of the tibia and in 11% on the lateral views of the femur. One case of aseptic loosening was observed during the follow-up period. There were no significant differences of clinical results between the patellar resurfacing TYAs and the without patellar resurfacing TKAs. CONCLUSION: We achieved favorable results when performing TKAs with the PS type Scorpio(R) system during mid to long term follow-up. There was no significant difference of clinical results between the patellar resurfacing and non resurfacing groups in our study.