Minimally invasive plate osteosynthesis for metastatic pathologic humeral fractures.
Because patients with metastatic bone disease may survive only 3 to 12 months, the goal of surgery for pathologic fractures is to attain rigid and durable internal fixation and immediate postoperative use of the upper extremity. Surgical options such as intramedullary nailing, plating, and insertion of prosthesis usually reinforced with bone cement have been proposed for pathological humeral fractures. We describe a 42-year-old man with a pathologic distal humeral fracture. The fracture location and lack of distal bone stock precluded the use of intramedullary nails. We performed minimally invasive plating by using a locking plate for bridging and stabilization of fracture. Minimally invasive plate osteosynthesis of the humeral shaft was developed to allow anterior plate and screw stabilization involving less soft tissue disruption and to theoretically improve healing rates and reduce complications, such as infection and iatrogenic radial nerve palsy. Plain radiographs showed stable consolidation of the fracture without screw loosening at the 7-month follow-up. Elbow range of motion was 120°, and the arm was stable without pain. Minimally invasive plate using a locking plate can provide stable fixation and allow early arm mobilization without protection and decrease the risk of operation-related complications, making it a useful surgical alternative in the treatment of pathologic humeral fractures.
Department of Orthopedic Surgery, Ilsan Paik Hospital, Inje University, Koyang-si, South Korea.
Suk Kyu
SK
Choo
Sung Jong
SJ
Woo
Hyoung Keun
HK
Oh
D000328:Adult; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery*; D001860:Bone Plates; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D006810:Humeral Fractures / Q000209:etiology / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D016896:Treatment Outcome