Kantonsspital St.Gallen

[Pathological Fractures of the Humerus: Experience with 76 Cases in a Musculoskeletal Oncology Centre]

Andreas Toepfer, U Lenze, F Pohlig, R Von Eisenhart-Rothe, L Gerdesmeyer, C Kirchhoff & N Harrasser


Pathological fractures can be caused by numerous local and systemic processes. The humerus is one of the commonest sites of pathological, tumour-associated fractures.

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.

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.

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.
citation Toepfer A, Lenze U, Pohlig F, Eisenhart-Rothe R v, Gerdesmeyer L, Kirchhoff C, Harrasser N. [Pathological Fractures of the Humerus: Experience with 76 Cases in a Musculoskeletal Oncology Centre]. Z Orthop Unfall 2016; 154:364-9.
type journal paper/review (Translation2::getLang(): unknown language "". Use Translation2::setLang() to set a default language.)
date of publishing 07-06-2016
journal title Z Orthop Unfall (154/4)
ISSN electronic 1864-6743
pages 364-9
PubMed 27273274
DOI 10.1055/s-0042-105160