Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2014; 81(6):365-370 | DOI: 10.55095/achot2014/050

Surgical Management and Outcome of Skeletal Metastatic Disease of the HumerusOriginal papers

P. Schwabe^*, M. Ruppert, S. Tsitsilonis, I. Melcher, K.-D. Schaser, S. Märdian

Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Germany

PURPOSE OF THE STUDY:
Evaluation of outcome after surgical treatment of humerus metastases with a focus on tumour and patient derived factors, timing and strategy of intervention, surgical outcome and complications.

MATERIAL AND METHODS:
Sixty-five patients with a mean age of 64.3 years (range 25-89) with 66 metastases of the humerus were surgically treated in a 7-year time-period and retrospectively reviewed.

RESULTS:
Renal cell carcinoma and breast cancer were the most abundant types of primary tumour. The mean time from diagnosis of primary tumour to first metastasis was 14.5 months (range 0-173). The mean time from diagnosis of metastasis to surgery was 21.4 months (range 0-173). 38/28 intramedullary nails/locking plates were used for 58/8 manifest/impending pathological fractures. Mean cumulative survival was 16.3 months and implant failure rate was 6.1% with a mean time from initial surgery to revision of 22.2-20.6 months.

CONCLUSIONS:
Our data indicate that treatment with intramedullary fixation or cement augmented plate osteosynthesis is successful for the vast majority of patients, but thorough clinical evaluation and precise decision making adapted to the patient's estimated life expectancy must be applied to avoid overtreatment or risk of implant failure.

Keywords: bone metastases, skeletal metastatic disease, humerus metastasis, pathologic fracture, impending fracture

Published: December 1, 2014  Show citation