Unlabelled: The humerus is a common site of metastatic tumor involvement and pathologic fracture. Intramedullary nailing is a treatment option that offers the benefit of protecting a long segment of diseased bone, but it is not without complications. This study aims to examine the survival, functional outcomes, and complications of patients treated with cement-augmented unlocked intramedullary nailing for actual and impending pathologic fractures of the humeral shaft.
Methods: From 2014 to 2019, 26 patients were treated with this technique. Functional outcomes were assessed using the Musculoskeletal Tumor Society scoring system. Outcome scores, complications, reoperations, and mortality were determined by retrospective chart reviews and direct patient examinations.
Results: The mean age at the time of surgery was 66.8 years. The mean follow-up was 20.2 months. Patients reported significant improvement in the mean Musculoskeletal Tumor Society score from 10.5 preoperatively to 26.1 after surgery ( < 0.001). Five patients died of disease during the follow-up period. One patient had intraoperative fracture propagation during implant placement, and one patient experienced a postoperative rotator cuff tear.
Discussion: Unlocked intramedullary nailing with cement augmentation is a reliable treatment method for actual and impending pathologic fractures of the humerus that results in favorable outcomes, including consistent pain relief and restoration of function.
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http://dx.doi.org/10.5435/JAAOSGlobal-D-20-00090 | DOI Listing |
J Orthop Case Rep
January 2025
Lokmanya Tilak Municipal Medical college, Sion Mumbai., India.
Introduction: Road traffic accidents (RTA) account for a sizable portion of morbidity and mortality globally, with a particularly high incidence among young and active individuals. Patients presenting with polytrauma require a multidisciplinary approach guided by protocols for advanced trauma life support.
Case Report: We report the case of a 31-year-old female, transferred-in to our center following primary care after an RTA on June 17th, 2023.
Eur J Trauma Emerg Surg
January 2025
AO Research Institute Davos, Davos, Switzerland.
Background: Digitally Enhanced Hands-on Surgical Training (DEHST) platform was introduced to overcome the lack of training capabilities for the challenging task of freehand distal interlocking of intramedullary nails. It demonstrates high perceived realism for surgeons, and novices perform significantly better after DEHST training. However, characterization of how performance improves remained unexplored.
View Article and Find Full Text PDFJ Clin Med
January 2025
Discipline of Physiotherapy, Faculty of Health Sciences, European University Miguel de Cervantes, C del Padre Julio Chevalier 2, 47012 Valladolid, Spain.
: Hip fractures are prevalent among the elderly and impose a significant burden on healthcare systems due to the associated high morbidity and costs. The increasing use of intramedullary nails for hip fracture fixation has inadvertently introduced risks; these implants can alter bone elasticity and create stress concentrations, leading to peri-implant fractures. The aim of this study is to investigate the outcomes of peri-implant hip fractures, evaluate the potential causes of such fractures, determine the type of treatment provided, assess the outcomes of said treatments, and establish possible improvement strategies.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Purpose: The use of intramedullary fixation of AO type 31-A1 fractures is rising, despite evidence of non-superiority when compared with extramedullary fixation. The aim of this study was to evaluate mobility and living status for extramedullary fixation (EMF) versus intramedullary fixation (IMF) in Dutch hospitals during the initial hospital stay and until three-months after trauma.
Methods: Data on patient characteristics, mobility, living status, complications, reoperation, and mortality were extracted from the Dutch Hip Fracture Audit Indicator Taskforce.
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