Pathological fractures of the humeral shaft

Background and Aims: To evaluate the results, complications and survival af ter intramedullary (IM) nailing of pathological humeral shaft fractures ass ociated with metastatic disease. Material and Methods: Sixteen patients (mean age 64 years) with 18 patholog ical fractures of the humeral shaft were treated by IM nailing in Oulu Univ ersity Hospital from 1987 to 1997. Retrospective evaluation of charts and r adiographs was carried out. Breast carcinoma and multiple myeloma were the most common diagnoses. The mean interval from diagnosis of malignancy to fr acture was 47 (1-168) months. Results: Mean duration of the operation was 62 (25-95) minutes and mean int raoperative blood loss was 200 (50-600) mi. Complications were rare. Surviv al 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 proc edure for treating pathological fractures of the humeral shaft.