title: Painful pathologic fracture of the humerus: percutaneous osteoplasty with bone marrow nails under hybrid computed tomography and fluoroscopic guidance.
abstract: A case of a 75-year-old patient with a painful pathologic humeral shaft fracture, with unacceptably high surgical risk and unsatisfactory analgesia is reported. In this case, impaired arm function and persistent pain with conservative management resulted in a poor quality of life. Palliation with image-guided percutaneous osteoplasty was considered. Because of potential cement leakage, inadequate fracture reduction, the site of the fracture, and the mobility of the joints in that area, image-guided percutaneous delivery of metallic bone marrow nails implanted together with polymethyl methacrylate (PMMA) osteoplasty was performed. This procedure achieved humeral shaft stabilization, bone fragment alignment, fracture reduction, and pain relief.
authors.affiliation: Interventional Radiology Unit, Institute for Cancer Research and Treatment, Strada Provinciale 135, Km 3.95, 10060 Candiolo, Turin, Italy. giovanni.anselmetti@ircc.it
authors.forename: Giovanni Carlo
authors.initials: GC
authors.lastname: Anselmetti
authors.forename: Antonio
authors.initials: A
authors.lastname: Manca
authors.forename: Gabriele
authors.initials: G
authors.lastname: Chiara
authors.forename: Sean
authors.initials: S
authors.lastname: Tutton
authors.forename: Gabriella
authors.initials: G
authors.lastname: Iussich
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Gino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grignani
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ortega
authors.forename: Nora
authors.initials: N
authors.lastname: Moselli
authors.forename: Daniele
authors.initials: D
authors.lastname: Regge
mesh_terms: D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use*; D001858:Bone Nails; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D010147:Pain Measurement; D010166:Palliative Care; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D015641:Radiography, Interventional / Q000379:methods*; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate