| Abstract [eng] |
Pathological humeral fracture is one of the most complicated pathologies faced by orthopedic traumatologists. It’s a complication of bone instability that is usually caused by tumors and osteoporosis. These diseases can often develop for a long time without causing any symptoms. This is particularly dangerous for the patient as these illnesses, especially oncologic ones, require treatment as early as possible. On the other hand, pathological fracture that already occurred poses a challenge to surgeons due to frequent reoperations, unstable bone structure and unpredictable patient health prospects. Intramedullary osteosynthesis is one of the main methods used to stabilize long bone fractures. Nowadays, there are many variations of intramedullary nails in terms of design, materials and methods used in operation. There are two cases of pathological humeral fracture presented here. Two male patients aged 57 and 67 years old arrived with arm pain, with deformity, reduced function and denies possibility of trauma. Patients’ medical history includes oncologic diseases (blader and renal clear cell carcinoma). Both patients were clinically and radiologically diagnosed with pathological humeral fracture and scheduled intramedullary osteosynthesis was performed. Postoperative radiographs showed good implant positioning. As there were no other complaints, the patient was discharged and continued with oncological treatment on an outpatient basis. Upon follow-up, the operative treatment was successful; however, the second patient (of 67 years) continued to have limited arm function and both patients exhibited slowed fracture healing. Aim of study – to investigate the causes, clinical features, and treatment of pathological humeral fractures using intramedullary osteosynthesis. Objectives: 1) To review literature about the causes, clinical presentation, and innovations in intramedullary osteosynthesis for pathological humeral fractures. 2) To present and evaluate clinical cases and discuss possible treatment alternatives based on the reviewed literature. Methods: A narrative literature review was conducted using PubMed, Web of Science, ScienceDirect, and Scopus databases. Lithuanian statistics were sourced from Lithuanian Institute of Hygiene. Based on the reviewed literature, the causes, diagnostics, and specificities of treatment with intramedullary osteosynthesis for pathological humeral fractures were described. Two clinical cases found at Vilnius Republican University hospital were presented and analyzed. |
