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  • Wedin, RikardKarolinska Institutet (author)

Complications and survival after surgical treatment of 214 metastatic lesions of the humerus

  • Article/chapterEnglish2012

Publisher, publication year, extent ...

  • Elsevier BV,2012

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  • LIBRIS-ID:oai:lup.lub.lu.se:91a61583-f5eb-45a2-af9a-a9d619003eb4
  • https://lup.lub.lu.se/record/3059778URI
  • https://doi.org/10.1016/j.jse.2011.06.019DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75964URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:125096830URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Background: The humerus is the second most common long-bone site of metastatic bone disease. We report complications, risk factors for failure, and survival of a large series of patients operated on for skeletal metastases of the humerus. Materials and methods: This study was based on 208 patients treated surgically for 214 metastatic lesions of the humerus. Reconstructions were achieved by intramedullary nails in 148, endoprostheses in 35, plate fixation in 21, and by other methods in 10. Results: The median age at surgery was 67 years (range, 29-87 years). Breast cancer was the primary tumor in 31%. The overall failure rate of the surgical reconstructions was 9%. The reoperation rate was 7% in the proximal humerus, 8% in the diaphysis, and 33% in the distal part of the bone. Among 36 operations involving an endoprosthesis, 2 were failures (6%) compared with 18 of 178 osteosynthetic devices (10%). In the osteosynthesis group, intramedullary nails failed in 7% and plate fixation failed in 22%. Multivariate Cox regression analysis showed that prostate cancer was associated with an increased risk of failure after surgery (hazard ratio, 7; P < 0.033). The cumulative survival after surgery was 40% (95% confidence interval [CI] 34-47) at 1 year, 21% (95% CI, 15-26) at 2 years, and 16% (95% CI, 12-19) at 3 years. Conclusions: Our method of choice is the cemented hemiprosthesis for pathologic proximal humeral fractures and interlocked intramedullary nail for lesions in the diaphysis. Pathologic fractures in the distal humerus are uncommon and associated with a very high reoperation rate. Level of evidence: Level IV, Case Series, Treatment Study. (C) 2012 Journal of Shoulder and Elbow Surgery Board of Trustees.

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  • Hansen, Bjarne H.Department of Orthopaedics, University Hospital, Aarhus, Denmark (author)
  • Laitinen, MinnaDepartment of Orthopaedics, University Hospital, Tampere, Finland (author)
  • Trovik, Clementrtment of Orthopaedics, Haukeland University Hospital, Bergen, Norway (author)
  • Zaikova, Olgament of Oncological Surgery, Norwegian Radium Hospital, Oslo, Norway (author)
  • Bergh, PeterDepartment of Orthopaedics, Sahlgren University Hospital, Gothenburg, Sweden (author)
  • Kalén, AndersÖstergötlands Läns Landsting,Linköpings universitet,Ortopedi,Hälsouniversitetet,Ortopedkliniken i Linköping(Swepub:liu)andka68 (author)
  • Schwarz-Lausten, GunnarDepartment of Orthopaedics, University Hospital, Herlev, Denmark (author)
  • Vult von Steyern, FredrikLund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Department of Orthopaedics, Lund University Hospital, Lund, Sweden(Swepub:lu)ort-fvu (author)
  • Walloe, AndersDepartment of Orthopaedics, Ullevaal Hospital, Oslo, Norway (author)
  • Keller, Johnnytment of Orthopaedics, University Hospital, Aarhus, Denmark (author)
  • Weiss, Rudiger J.Karolinska Institutet (author)
  • Karolinska InstitutetDepartment of Orthopaedics, University Hospital, Aarhus, Denmark (creator_code:org_t)

Related titles

  • In:Journal of Shoulder and Elbow Surgery: Elsevier BV21:8, s. 1049-10551058-27461532-6500

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