Combination of Elastic Nail(s) and Cementoplasty to Treat Pathological Fractures in Long Bones of the Upper Limb.

Abstract

Objective: To describe and study retrospectively the combination of elastic nails and cementoplasty to stabilize pathological fractures in the upper limb and present the results on pain and mobility.

Materials and methods: Between January 2022 and April 2024, six patients with a median age of 65 were treated with elastic nailing and cement injection. Pathological fractures were located in the clavicle (n = 3), humerus (n = 1) and radius (n = 2). Displacement at the fracture site was noted in two cases.

Results: All nails were inserted successfully. Two nails were used for the humerus (n = 1) and the radius (n = 2), and a single nail was used for the clavicle (n = 3). A median volume of 6.5 cc of PMMA was injected. Median duration of the procedure was 155 min. Median pain score dropped from 8/10 the day before intervention to 3.5/10 at 10 days of follow-up and 3/10 at one-month follow-up. Three patients could move their upper limb without limitation. For the five patients for whom imaging was available, no fracture displacement was recorded at a median last follow-up of 3 months. There was no delayed complication.

Conclusion: The combination of elastic nail and cementoplasty is feasible and allows to reduce pain and restore limb function. It may offer an alternative to patients suffering from pathological fractures in the upper limb and who are not candidates for surgery.