J Korean Orthop Assoc.  2016 Dec;51(6):509-514. 10.4055/jkoa.2016.51.6.509.

Therapeutic Approach to Humeral Pathologic Fracture Caused by Benign Bone Tumor

• Kim JI
• Kim UJ
• Moon NH
• Kim HT
• Ahn TY
• Lee IS
• Song YS
• Choi KU

• KMID: 2364303
• DOI: http://doi.org/10.4055/jkoa.2016.51.6.509

Abstract

PURPOSE
The purpose of this study is to suggest an appropriate therapeutic approach by making a comparison between conservative therapy and surgical therapy for a pathologic fractures of the humerus caused by benign bone tumor.
MATERIALS AND METHODS
We selected 15 cases with a pathologic fracture of the humerus caused by benign bone tumor from January 2000 to April 2014 to evaluate the fracture union period and remission of primary bone tumor. Eight cases were treated with conservative therapy, and 7 cases by surgical therapy. The mean age was 13.1 years, and the age range was between 1 year and 19 years; there were 8 male cases and 7 female cases. The mean follow-up period was 24.9 months, with a range from 4 months to 72 months. We evaluated the remission of primary benign tumor in accordance with the "˜Modified Neer classification' system.
RESULTS
There was no statistically significant difference in age, sex, and mean follow-up period between the two groups. The pathologic fracture was united in all cases without secondary displacement. There was no statistically significant difference in the fracture union period (p=0.164) and remission of primary benign tumor (p=0.931) between the two groups.
CONCLUSION
We suggest that both conservative and surgical therapies can be a treatment for pathologic fracture of the humerus caused by benign bone tumor.

Keyword

humerus; benign bone tumor; pathologic fracture; conservative therapy

MeSH Terms

Female
Follow-Up Studies
Fractures, Spontaneous*
Humans
Humerus
Male

Figure

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  Figure 1 Cases treated with conservative therapy. (A) Initial anteroposterior and lateral radiographs show spiral type humerus shaft fracture with cystic bone tumor. (B) After 1.2 months, functional brace was applied. No significant interval change was observed. (C) After 2.4 months, fracture was healed and the patient had no pain.

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  Figure 2 Cases treated with surgical therapy. (A) Initial anteroposterior and lateral radiographs show proximal humerus fracture with cystic bone tumor. (B) Curettage and allogenic bone grafting was done. (C) After 1.9 months, fracture was healed. (D) After 1 year, cystic bone tumor was recurred. (E) Second curettage and allogenic bone grafting was performed. (F) After 1.9 months of the second operation, there was no sign of recurrence.

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