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Pathological fractures of the humeral shaft.

BACKGROUND AND AIMS
To evaluate the results, complications and survival after intramedullary (IM) nailing of pathological humeral shaft fractures associated with metastatic disease.


MATERIAL AND METHODS
Sixteen patients (mean age 64 years) with 18 pathological fractures of the humeral shaft were treated by IM nailing in Oulu University Hospital from 1987 to 1997. Retrospective evaluation of charts and radiographs was carried out. Breast carcinoma and multiple myeloma were the most common diagnoses. The mean interval from diagnosis of malignancy to fracture was 47 (1-168) months.


RESULTS
Mean duration of the operation was 62 (25-95) minutes and mean intraoperative blood loss was 200 (50-600) ml. Complications were rare. Survival after the fracture averaged 160 (39-511) days. Two patients (3 fractures) were alive at the time of the evaluation, with satisfactory or good pain relief.


CONCLUSIONS
Pathological fracture of the humeral shaft occurs late in the course of malignant disease. IM nailing is a safe, rapid and effective procedure for treating pathological fractures of the humeral shaft.