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Cemented-augmented fixation of metastatic humeral lesions without segmental bone loss results in reliable outcomes.

BACKGROUND: Treatment of metastatic lesions to the humerus is dependent on patient's pain, lesion size and location, and post-operative functional goals. Surgical options include plate or nail fixation [open reduction internal fixation (ORIF)], or endoprosthetic replacement (EPR), with cement augmentation. The objective of this study was to perform a single institution retrospective analysis of outcomes by method of reconstruction, tumor volume, and pathologic diagnosis. METHODS: The records of 229 consecutive patients treated surgically for appendicular metastatic disease from 2005-2018 at o

Modular prostheses in the treatment of proximal humerus metastases: review of 40 cases.

BACKGROUND: The humerus is the second most common site of metastatic bone disease involving long bones. Tumors which have a predilection for dissemination to bone are those of breast, prostate, thyroid, lung and kidney. The rationale for surgical treatment of these lesions is to prevent or treat pathological fractures in order to relieve pain and improve function. MATERIALS AND METHODS: Forty patients who had resection of the proximal humerus for metastatic bone disease and reconstruction with a modular prosthesis were retrospectively reviewed. RESULTS: Mean functional outcome was 73.1% (Enn

Pathological fracture of primary lymphoma of bone: A case report on diagnosis and novel surgical management.

Primary lymphoma of bone (PLB) is an uncommon malignancy, representing ~4-5% of primary malignant bone tumors and 1% of all malignant lymphomas. Diffuse large B-cell lymphoma (DLBCL) is the most common subtype, accounting for ~80% of cases, and is highly curable with appropriate treatment. Therefore, accurate and timely diagnosis is crucial for favorable outcomes. The current study presents a 42-year-old male with primary DLBCL of the proximal humerus. The initial diagnosis was challenging due to overlapping morphological features with other small round cell tumors like Ewing's sarcoma and sma

Clinical outcomes and complications of surgical interventions for multiple myeloma lesions in the extremities and pelvis: A retrospective clinical study.

OBJECTIVE: This study aimed to assess the pain and functional status of patients who underwent various surgical interventions for the stabilization of selected multiple myeloma (MM) lesions in the extremities and pelvis and to investigate the rate of complications requiring reintervention. METHODS: Patients with MM who underwent various surgical interventions for the extremity or pelvic lesions were retrospectively reviewed. Change in the pain intensity was assessed using visual analogous scale (VAS) preoperatively, at the time of discharge, and at the final follow-up. Functional status was a

[Neonatal cervical artery dissection secondary to birth trauma].

Cervical artery dissection is rare in the neonatal period and is most often caused by birth injury during dystocic labor. The severity of this pathology is due to the possibility of serious neurological complications. We report a case of a male newborn who was born vaginally after shoulder dystocia. The extraction was difficult, resulting in a fracture of the right humerus. On the second day of life, the child presented generalized clonic convulsions. Computed tomography of the brain showed an ischemic stroke in the territory of the right middle cerebral artery, the territory of the right post

[Arthroscopic stabilization of a primary traumatic dislocation of the glenohumeral joint].

PURPOSE OF THE STUDY: The authors present their experience with arthroscopic stabilization of a primary traumatic dislocation of the glenohumeral joint in young patients. MATERIAL: In up to 80% of patients younger than 25 years, traumatic dislocation of the glenohumeral joint is associated with its recurrence within one year of treatment even in well performed conservative therapy. Repeated dislocations gradually damage the joint and eventually result in the development of arthritis. The articular capsule becomes loose, glenoid surface is reduced and cartilage of the humeral head is affected.

Outcomes in dogs undergoing surgical stabilization and non-stereotactic radiation therapy for axial and appendicular bone tumors.

BackgroundInformation on dogs that undergo radiation therapy (RT) with non-stereotactic protocols in addition to surgical stabilization with implant placement for treatment of bone tumors is limited.ObjectiveOur primary objectives were to describe the clinical characteristics as well as short- and long-term outcomes, including complications, function, and disease progression, in dogs that underwent both surgical stabilization with implant placement and non-stereotactic RT for local treatment of a bone tumor.MethodsA bi-institutional retrospective case series was performed.AnimalsEight client-o

Multicenter, retrospective comparison of implant survival, complications and cost between plate and screw and intramedullary nail fixation for metastatic lesions of the diaphyseal humerus.

BACKGROUND: The humerus is a common site of metastatic disease that can be fixated with either plate and screw or intramedullary nail (IMN) constructs. A multicenter retrospective comparison study was undertaken to compare implant survival, complication rate and cost between the two constructs. No prior studies have included a cost comparison. METHODS: Databases of two academic practices were queried retrospectively to identify patients with metastases of the humerus. Inclusion criteria were a lesion in the proximal metaphysis to distal diaphysis and amenable to both implant options with avai

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… A review of studies reporting on the rate of PE after the treatment of both metastatic and non-metastatic humeral fracture suggests a rate between 1.3% and 5.1% ( 5 , 14 ). The rate reported in the nail group of 6.9% is not significantly higher and is likely attributable to the small sample size. … Pulmonary embolism after operative treatment of proximal humeral fractures. J Shoulder Elbow Surg 2007;16:782-3. 10.1016/j.jse.2006.12.004 15. Piccioli A, Maccauro G, Rossi B, et al. Surgical treatment of pathologic fractures of humerus. Injury 2010;41:1112-6. 10.1016/j.injury.2010.08.015 16. …

Elbow hemiarthroplasty with a 3D-printed prosthesis for distal humeral bone defects after tumor excision: a case report.

INTRODUCTION: The distal humerus is a rare site for primary and metastatic bone tumors. Due to the scarcity of cases and lack of standardized surgical strategies, it is often difficult for surgeons to choose the right choice. The application of a 3D-printed prosthesis with hemiarthroplasty for the treatment of the distal humerus after tumor resection can be a very effective option. CASE PRESENTATION: We present a clinical case of a 3D-printed distal humeral prosthesis for the treatment of bone defects caused by metastatic bone tumors. The preoperative evaluation was aggressively performed, an

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… Hemiarthroplasty for irreparable distal humeral fractures: medium-term follow-up of 42 patients. Bone Joint J. 2015;97–B(10):1377–84. doi: 10.1302/0301-620X.97B10.35421. 22. Dunn J, Kusnezov N, Pirela-Cruz M. Distal humeral hemiarthroplasty: indications, results, and complications. …

Preliminary results of a new intercalary modular endoprosthesis for the management of diaphyseal bone metastases.

OBJECTIVES: This study aims to evaluate functional outcomes of patients and to analyze complication rates of modular intercalary endoprosthetic reconstruction after resection of metastatic diaphyseal bone lesions. PATIENTS AND METHODS: Between December 2017 and February 2020, 22 patients (15 males, 7 females; median age: 64.2 years; range, 49 to 91) who underwent reconstruction with modular intercalary endoprostheses for metastatic bone tumors at five different centers were retrospectively analyzed. Age, sex, diagnosis, follow-up duration, previous treatments of patients, and resection length

Glenohumeral Instability and Clinical Outcomes Following Proximal Humerus Resection and Megaprosthesis Implantation: A Systematic Review.

Background: Glenohumeral instability is one of the most frequent and clinically impactful complications following proximal humerus resection and reconstruction with a megaprosthesis, especially in patients treated for bone tumors or complex fractures. Its incidence, risk factors, and influence on functional recovery remain variably reported in the literature. Methods: A systematic review was conducted according to PRISMA guidelines, searching PubMed, Scopus, and Google Scholar up to April 2025. Studies reporting on postoperative instability, dislocation, functional outcomes (MSTS, DASH), and r

Joint-preserving palliative surgery using self-locking screws of intramedullary nail and percutaneous cementoplasty for proximal humeral metastasis in the advanced cancer patients.

BackgroundWe introduced a palliative joint-preserving surgery using proximal self-locking screws of intramedullary (IM) nail and percutaneous cementoplasty (PC) in patients with proximal humeral metastases, including the head and neck, and evaluated the outcome of the surgical method.MethodsTwenty-three patients (mean age = 63.0 ± 11.8 years, M:F = 14:9) had IM nailing with a self-locking screw system and PC for the treatment of humeral head and neck metastases. Usually, three proximal locking screws were inserted after IM nailing, and 20.9 ± 8.0 ml of polymethylmethacrylate (PMMA) bone cement

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… A new approach for the treatment of proximal humeral fractures using the TRIGEN proximal humeral nail. Eur J Orthop Surg Traumatol. 2014;24:467–474. doi: 10.1007/s00590-013-1229-7. 9. Kim JH, Kang HG, Kim JR, Lin PP, Kim HS. …

Apical lung mass-A rare presentation of multiple myeloma.

Multiple myeloma is a neoplastic proliferation of immunoglobulin-producing plasma cells with clinical features resulting from infiltration of plasma cells into bones and other organs. Multiple myeloma manifesting as an apical lung mass is less common and very few cases have been reported. We report the case of a 50-year-old female who presented with an apical lung mass which happened to be multiple myeloma arising from the upper ribs into the lung. At the time of diagnosis, patient had axillary lymph node metastasis with extensive bony involvement. This case report and literature review provid

Pathological Fractures in Rare Bone Diseases: Clinical Cases.

Rare bone diseases, though uncommon, present significant diagnostic and therapeutic challenges due to their clinical variability and overlapping symptoms with more prevalent conditions. This article describes a clinical case series of three patients with bone fragility fractures caused by rare bone diseases - primary hyperparathyroidism with brown tumor, Gorham-Stout disease, and alkaptonuria - treated at the Department of Orthopedic and Traumatology of Pisa University Hospital between 2018 and 2023. Each case highlights the diagnostic complexities, including inconclusive biopsies, nonspecific

Principles of Management of Extremity Skeletal Metastasis.

Understanding the epidemiology of extremity skeletal metastasis and the factors deciding the treatment decision-making are essential in developing a diagnostic and treatment strategy. This leads to optimum care and reduces disease-related burden. With the evolution of medical, radiation therapy, and surgical methods, cancer care has improved the quality of life for patients with improved survival and functional status in patients with skeletal metastasis. Based on the currently available literature, we have described a step-wise evaluation and management strategy of metastatic extremity bone d

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… A study of the surgical treatment of 166 pathologic humeral and femoral fractures Clin Orthop Relat Res 1990 251 213 9 2295178 35 Weiss KR Bhumbra R Biau DJ Griffin AM Deheshi B Wunder JS Fixation of pathological humeral fractures by the cemented plate technique J Bone Joint Surg Br 2011 93 1093 7 21768635 …

Ultra-short stem intercalary prosthetic reconstruction for joint preservation in metaphyseal tumor management: a retrospective review of twenty-five cases.

PURPOSE: This study evaluates the outcomes, survival, and ASL incidence of ultra-short stem intercalary prosthetic reconstruction for tumors involving the metaphysis of bone. METHODS: A retrospective analysis of 25 patients treated at two centers with wide resection for primary or metastatic bone tumors (femur, tibia, humerus) followed by reconstruction using ultra-short stem intercalary prostheses combined extracortical plates. Clinical outcomes were assessed using the Visual Analogue Scale (VAS) and Musculoskeletal Tumor Society (MSTS) score. Survival rates were calculated using the Kaplan-

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… fracture with bone dissolution at the fracture site. b MRI preoperatively showing an abnormal soft tissue mass at the fracture site. c Complete resection of tumor-invaded tissue at the pathological fracture site, with the proposed prosthetic implant. d AP radiograph postoperatively showing appropriate … Intercalary prosthetic reconstruction for pathologic diaphyseal humeral fractures due to metastatic tumors: outcomes and improvements. J Shoulder Elbow Surg. 2018;27(11):2013–20. 10.1016/j.jse.2018.03.027. 19. Guder WK, Hardes J, Gosheger G, Nottrott M, Streitbürger A. …

Эффективность хирургического вмешательства в лечении патологических нарушений верхней конечности: серия ретроспективных дел.

Мы проводим ретроспективный анализ пациентов с патологическими переломами в результате аномалий верхних конечностей, уделяя особое внимание оценке применяемых методов лечения. МАТЕРИАЛЫ И МЕТОДЫ: Мы ретроспективно изучали 10 больные метастатическими опухолями костей верхних конечностей. К числу переменных исследований относятся: место опухоли, первичная патология, продолжительность от первого диагноза первичного повреждения до возникновения патологического перелома, использование костно-модифицирующих препаратов, хирургическая техника, адъютантная терапия, послеоперационная функциональная оцен

Revision with Locking Compression Plate by Compression Technique for Diaphyseal Nonunions of the Femur and the Tibia: A Retrospective Study of 54 Cases.

Nonunion after diaphyseal fracture of the femur or the tibia is a common but difficult complication for treatment. Currently, the main treatment modalities include nail dynamization, exchange nailing, and bone transport, but revision with compression plating in these nonunions was rarely reported. To evaluate the outcomes of compression plating in the treatment of femur and tibia shaft nonunions, we retrospectively reviewed 54 patients with diaphyseal nonunion of the tibia or the femur treated with locking compression plate (LCP) by compression technique. There were 46 aseptic and 8 septic non

Longitudinal survival trends of patients with cancer with surgically managed appendicular metastatic bone disease: systematic review.

BackgroundAdvances in systemic cancer therapies have improved survival for patients with metastatic carcinoma; however, it is unknown whether these advances have translated to improved survival for patients with appendicular metastatic bone disease (A-MBD) after orthopedic interventions. We conducted a study to evaluate the trend in overall survival for patients who underwent orthopedic surgery for A-MBD between 1968 and 2018.MethodsA systematic search of Embase and Medline to identify studies published since 1968 evaluating patients treated with orthopedic surgery for A-MBD was conducted for

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… Fixation of pathological humeral fractures by the cemented plate technique. J Bone Joint Surg Br 2011;93:1093–7. 48. Samsani SR, Panikkar V, Georgiannos D, et al. Subtrochanteric metastatic lesions treated with the long gamma nail. Int Orthop 2003;27: 298–302. 49. …