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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...

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Autores principales: Choi, Eun-Seok, Han, Ilkyu, Cho, Hwan Seong, Park, In Woong, Park, Jong Woong, Kim, Han-Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114260/
https://www.ncbi.nlm.nih.gov/pubmed/27904730
http://dx.doi.org/10.4055/cios.2016.8.4.458
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author Choi, Eun-Seok
Han, Ilkyu
Cho, Hwan Seong
Park, In Woong
Park, Jong Woong
Kim, Han-Soo
author_facet Choi, Eun-Seok
Han, Ilkyu
Cho, Hwan Seong
Park, In Woong
Park, Jong Woong
Kim, Han-Soo
author_sort Choi, Eun-Seok
collection PubMed
description 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.
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spelling pubmed-51142602016-12-01 Intramedullary Nailing for Pathological Fractures of the Proximal Humerus Choi, Eun-Seok Han, Ilkyu Cho, Hwan Seong Park, In Woong Park, Jong Woong Kim, Han-Soo Clin Orthop Surg Original Article 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. The Korean Orthopaedic Association 2016-12 2016-11-04 /pmc/articles/PMC5114260/ /pubmed/27904730 http://dx.doi.org/10.4055/cios.2016.8.4.458 Text en Copyright © 2016 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Choi, Eun-Seok
Han, Ilkyu
Cho, Hwan Seong
Park, In Woong
Park, Jong Woong
Kim, Han-Soo
Intramedullary Nailing for Pathological Fractures of the Proximal Humerus
title Intramedullary Nailing for Pathological Fractures of the Proximal Humerus
title_full Intramedullary Nailing for Pathological Fractures of the Proximal Humerus
title_fullStr Intramedullary Nailing for Pathological Fractures of the Proximal Humerus
title_full_unstemmed Intramedullary Nailing for Pathological Fractures of the Proximal Humerus
title_short Intramedullary Nailing for Pathological Fractures of the Proximal Humerus
title_sort intramedullary nailing for pathological fractures of the proximal humerus
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114260/
https://www.ncbi.nlm.nih.gov/pubmed/27904730
http://dx.doi.org/10.4055/cios.2016.8.4.458
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