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Locked intramedullary nailing of symptomatic metastases in the humerus.

Authors
  • Spencer, S J
  • Holt, G
  • Clarke, J V
  • Mohammed, A
  • Leach, W J
  • Roberts, J L B
Type
Published Article
Journal
The Journal of bone and joint surgery. British volume
Publication Date
Jan 01, 2010
Volume
92
Issue
1
Pages
142–145
Identifiers
DOI: 10.1302/0301-620X.92B1.22399
PMID: 20044693
Source
Medline
License
Unknown

Abstract

The humerus is a common site for skeletal metastases in the adult. Surgical stabilisation of such lesions is often necessary to relieve pain and restore function. These procedures are essentially palliative and should therefore provide effective relief from pain for the remainder of the patient's life without the need for further surgical intervention. We report a retrospective analysis of 35 patients (37 nails) with symptomatic metastases in the shaft of the humerus which were treated by locked, antegrade nailing. There were 27 true fractures (73.0%) and ten painful deposits (27.0%). Relief from pain was excellent in four (11.4%), good in 29 (82.9%) and fair in two (5.7%) on discharge. Function was improved in all but one patient. One case of palsy of the radial nerve was noted. The mean postoperative survival was 7.1 months (0.2 to 45.5) which emphasises the poor prognosis in this group of patients. There were no failures of fixation and no case in which further surgery was required. Antegrade intramedullary nailing is an effective means of stabilising the humerus for the palliative treatment of metastases. It relieves pain and restores function to the upper limb with low attendant morbidity.

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