Title: Palliative Surgery for Pathological Fracture of Humerus by Intramedullary Interlocking Nail: Case Report
Authors: Dr Abhimanyu Singh, Dr Prasad Chaudhari, Dr Sanjay Dhar, Dr Abhay Agarwal, Dr Naba Krishna Gohain
DOI: http://dx.doi.org/10.18535/jmscr/v3i9.61
Abstract
A 54 year old female came to D.Y.Patil Hospital Orthopaedics Unit 3 OPD for consultation in the month of October 2014.It was diagnosed to be pathological fracture of right humerus secondary to right-sided breast carcinoma after thorough history-taking, clinical examination & diagnostic work-up. Patient was immobilized in a functional brace & was advised to follow-up after the completion of her chemotherapy.
In April 2011,she was a known case of colloid goitre who was diagnosed for a lump on her right breast. On 07/05/2011,FNAC was done which was suggestive of hypercellular smear showing duct carcinoma cells on haemorrhagic background & the conclusion was a malignant breast lesion. She underwent LOBC with SCNL biopsy on 03/06/2011
Later she underwent 6 cycles of chemotherapy from September 2014 to January 2015.Drugs used were Gemcitabine + Carboplatin, administered on D1 & D8 of each cycle with an interval of 3 weeks from the next.
She was planned for surgery on 03/03/2015 prior to which she was sent for embolization to Tata Memorial Hospital on 02/03/2015.
The surgery performed was “Debulking of the tumour with Intramedullary Interlocking Nailing & Intercalary bridging with antibiotic impregnated bone cement.”(Fig.6,7,8&9)
Results & Observations:Elbow range of motion exercises & smiley ball squeezing hand exercises was started from post-operative day 2.After a week, shoulder range of motion exercises were started. Patient was discharged after suture removal on post-operative day 14.On follow-up, after 2 weeks patient had both right shoulder & elbow range of motion full & free.
Conclusion: Intramedullary interlocking nailing proved to be an effective & stable internal fixation modality for pathological fracture of humerus which brought early pain relief& mobilization of the affected extremity.