[Pathological Fractures of the Humerus: Experience with 76 Cases in a Musculoskeletal Oncology Centre].
BACKGROUND
Pathological fractures can be caused by numerous local and systemic processes. The humerus is one of the commonest sites of pathological, tumour-associated fractures.


METHODS
In a retrospective study, 76 cases of pathological fractures of the humerus were analysed; 57 (75 %) were caused by a malignant disease, 19 fractures were associated with benign musculoskeletal disorders (25 %). The grade of the tumour, treatment strategy, intra- and postoperative complications, and survival rates in malignant tumours were documented.


RESULTS
Two thirds of fractures were localised in the proximal third of the humerus. In 59 % of patients, malignant lesions were metastases (mainly renal cell, breast, lung and prostate cancer), followed by haemato-oncological diseases and primary sarcomas. Most benign tumours were simple bone cysts and enchondromas. A total of 70 patients were treated surgically and only 6 conservatively. Most malignant tumours were treated with compound osteosynthesis and tumour prostheses. Complications in both groups were rare.


CONCLUSIONS
The demographic transition - with an increasing number of malignancies on the one hand and improved life expectancy under modern, adjuvant therapies on the other - will become a challenge in the treatment of pathological fractures of the humerus for a variety of disciplines.
Schön Klinik Harlaching.
A
A
Toepfer
Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München.
U
U
Lenze
Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München.
F
F
Pohlig
Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München.
R von
Rv
Eisenhart-Rothe
Orthopädie, Universitätsklinikum Schleswig-Holstein Campus Kiel.
L
L
Gerdesmeyer
Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der Technischen Universität München.
C
C
Kirchhoff
Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München.
N
N
Harrasser
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D015984:Causality; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data*; D005598:Fractures, Spontaneous / Q000601:surgery*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006810:Humeral Fractures / Q000453:epidemiology* / Q000601:surgery*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D055815:Young Adult