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.