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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Surgical treatment of humeral metastatic tumors

1
Department of Orthopedics and Traumatology
2
Department of Surgery, Kaunas University of Medicine, Lithuania
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Author to whom correspondence should be addressed.
Medicina 2009, 45(8), 607; https://doi.org/10.3390/medicina45080079
Received: 8 October 2008 / Accepted: 6 August 2009 / Published: 11 August 2009
Objective. To evaluate the functional outcome and pain control in patients after resection of humeral metastases.
Material and methods. A prospective randomized study of 24 cases of metastatic disease of the humerus with an associated pathologic fracture was carried out. The selected cases were divided into two groups based on the using methylmethacrylate cement for fracture fixation. Group 1 (n=12) included all cases in which the fracture was treated with bone cement augmentation. Group 2 (n=12) included all cases in which the fracture was treated without bone cement augmentation. Functional outcome was evaluated according to the American Musculoskeletal Tumor Society system.
Results
. Good and excellent pain control was achieved in 95% of cases in both groups. Functional outcome after resection of humeral metastases and pathological fracture fixation was significantly better in Group 1. Total function in five patients (45%) accounted for 86% and in three patients (25%) for 83% of full normal upper extremity function, whereas in Group 2, total function in six patients (50%) accounted for 70% and in three patients (25%) for 83% of full normal upper extremity function. The rate of fixation failure was significantly greater in Group 2, where fixation instability was observed in 50% (n=6) of cases (P=0.03). There were no significant differences in complication rate (in 50% of cases, mechanical instability occurred after fixation with intramedullary nail and in 50% of cases after fixation with plates).
Conclusions
. The introduction of bone cement as an adjunct to fixation of pathologic fracture improved clinical results and reduced the rate of fixation failure.
Keywords: metastatic bone tumors; fixation of pathologic fractures; bone cement; methylmethacrylate metastatic bone tumors; fixation of pathologic fractures; bone cement; methylmethacrylate
MDPI and ACS Style

Toliušis, V.; Kalesinskas, R.J.; Kiudelis, M.; Maleckas, A. Surgical treatment of humeral metastatic tumors. Medicina 2009, 45, 607.

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