Interlocking nail fixation for treatment of pathological fractures of the shaft of the humerus

ABSTRACT

Fifteen patients 14 with pathological fracture and one with impending pathological fracture of the shaft of the humerus due to bone metastasis were treated by interlocking nail fixation. There were seven male and eight female patients. Their mean age was 58 years [range, 40 to 71 years]. The primary malignant tumor was breast adenocarcinoma in 5, bladder transitional cell carcinoma in 1, multiple myeloma in 5, renal cell carcinoma in 2 and adenocarinoma with unknown origin in 2 patients. The average time from diagnosis of malignancy to pathological fracture was 42 months [range, zero to 85 months]. All interlocking nails were performed in closed antegrade fashion and all except one were statically locked. The mean follow-up period was 18 months [range, 15 to 25 months]. Excellent and good results were obtained in 11 patients [73%] and fair results in 4 patients [27%]. All patients had improvement in the functional use of the upper extremity after fixation. Pain relief was obtained in all patients. Eleven fractures united at an average period of 17 weeks [range, 15 to 22 weeks]. Complications recorded in this series were radial nerve palsy in one patient, superficial wound infection in 2 patients and implant loosening due to tumor progression in one patient. Interlocking nail fixation of pathological fracture of the humerus provides pain relief, immediate stability and early return of function of the upper extremity. Operative time is relatively short and morbidity is low