Fery A, Horle G, Krakowski I, Metz R, Chardot C, Sommelet J
Clinique de Traumatologie et d'Orthopédie, Nancy.
J Chir (Paris). 1988 Dec;125(12):721-9.
Surgical treatment of metastasis disease of the humerus was applied for 46 lesions among 42 patients, i-e 22% of overall osteosyntheses for skeletal metastasis. Two patients only are still alive at 3 and 4 years. The mean survival time is 8.1 months and at 3 months 50% died. Metastasis disease of the humerus becomes evident late during the evolution of the primary cancer, but 26% are revealing lesions. For 9.5% the primary tumor remains unknown. After review of the surgical methods generally used, indirect osteosynthesis by intra-medullary pinning according to Hackethal, without bone cement, is alleged. So the arm is immediately mobilized and a complementary irradiation is applied in post-operative. Prophylactic fixation of impending fractures is encouraged in order to suppress pain, and for better function. This paper demonstrates the changing concept of internal fixation of pathologic fractures and recommends intra-medullary nailing or pinning.
对42例患者的46处肱骨转移瘤病灶实施了手术治疗，即占骨骼转移瘤全部骨固定术的22%。仅有2例患者分别在3年和4年后仍存活。平均生存时间为8.1个月，3个月时50%的患者死亡。肱骨转移瘤在原发性癌症进展过程中出现较晚，但26%为首发病灶。9.5%的患者原发性肿瘤仍不明。在回顾了一般采用的手术方法后，主张采用哈克塔尔法进行无骨水泥的髓内针间接骨固定。这样手臂可立即活动，并在术后进行辅助放疗。为了减轻疼痛并改善功能，鼓励对即将发生的骨折进行预防性固定。本文阐述了病理性骨折内固定观念的转变，并推荐髓内钉固定或髓内针固定。
