[Orthopod] Re: PATHOLOGICAL # SHAFT HUMERUS


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[Orthopod] Re: PATHOLOGICAL # SHAFT HUMERUS

orthonet at gmail
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Apr 29, 2008, 7:12 PM

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[Orthopod] Re: PATHOLOGICAL # SHAFT HUMERUS	Can't Post

Our usual workup is routine bloodwork including Ca profile to make sure they
are not hypercalcemic, PSA.
CXR, CT scan chest and abdo looking for primary (rule out renal cell), Bone
scan. Examine thyroid, abdomen.

If it is a metastatic lesion then our preferred treatment is to perform an
open reduction, curettage of the tumor, fill the canal retrograde and
anterograde with cement and then apply a DCP plate once cement hard. In the
lab our tumor service has shown that this construct is biomechanically
better in torsion than an IM nail. In addition it avoids the risks of
shoulder pain from IM nails and nerve injury that has been shown in several
of the studies of IM nails vs plating of humerus shaft fractures ie.
McCormick et al.

If it appears to be a primary then a biopsy is required as well as
crossectional imaging ie. MRI and then definitive treatment planned.

Best regards

Christian
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Christian Veillette M.D., MSc., FRCSC
Shoulder and Elbow Reconstructive Surgery
Toronto Western Hospital, University Health Network
www.uhn.on.ca
www.orthonet.ca
www.orthopaedicweblinks.com
www.orthogate.org
Office: (416) 603-5929
Cell:(647) 200-9074
Fax:(866) 223-6624
Email: orthonet@gmail.com
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