Treatment of pathologic fractures or impending fractures of the humerus with Rush rods and methylmethacrylate. Experience with 55 cases in 54 patients, 1968-1977.

A retrospective study of 54 patients with established or impending pathologic humeral fractures was done to evaluate the technique of intramedullary fixation with a Rush rod, during the period from 1968 to 1977. Breast carcinoma, multiple myeloma, and hypernephroma were the most common metastatic tumors. Primary tumors included Ewing's sarcoma and a low-grade chondrosarcoma, in which case the patient refused any other form of treatment. An anterolateral incision was used to expose the fracture site and a deltoid-splitting incision to introduce the Rush rod. Thirty-eight of the 55 procedures utilized methylmethacrylate to help stabilize the fracture. All patients had relief of their preoperative pain after the procedure. Seven patients subsequently experienced pain: four had proximal migration of the Rush rod with impingement, three of which required removal of the Rush rod; three other patients had discomfort two years postoperatively. All patients except one had good functional motion. Six patients had complications: three with proximal migration of the Rush rod, two with transient subluxation of the humeral head, and one with limited glenohumeral motion secondary to a technical error. This procedure provides significant pain relief and maintains function.