hany_52 at yahoo
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Apr 29, 2008, 3:59 PM
Post #1 of 1
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[Orthopod] Re: PATHOLOGICAL # SHAFT HUMERUS
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Dear Dr. Amal..
I think its better to start with bone scan to identify the hot spots elsewhere, on which u can then concentrate ur x-ray and MRI if needed to help grading of the tumor, core biopsy may help to identify the primary...if the humeral lesion proved to be a secondary, closed nailing will be a good option, but the question is : is it better to use a thin, un-reamed nail (as a palliative ttt. only) to avoid dissimination of tumor cells, or to use a thick reamed one aiming at healing after irradiation if the tumor is radio-sensitive..?
Hany Al-elesh
Prof. Ortho. Surg.
Faculty of Medicine
Zagazig - Egypt
amalbasakortho <amal_basak@dataone.in> wrote: Dear Doctors,
A male patient aged 65 yrs admitted to-day with a pathological # shaft of humerus (Lt) after a trivial injury. He has H/O CVA 3 years ago, at present (Rt) sided hemiparesis. Patient is hypertensive taking drugs for this. No other problems.
Blood--Hb-12.6, TC-9800, N-80, L-17, ESR-5, Sugar(R)-101, Urea-26, Creatinine-1.2. Chest x-ray-NAD.
Cause of # - ? secondary metastasis.
What investigations to be done in such cases?
What should be the plan of management in such cases?
Attaching the x-ray pictures herewith.
Thanking you,
DR. AMAL BASAK, M.S.(Ortho)
Consultant Orthopaedic Surgeon,
Paramount Hospital,
Siliguri- 734405
West Bengal
INDIA.
Phones-9474354522(mob)
e-mail-amal_basak@dataone.in
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