LIMITED RECOMMENDATION A single small, retrospective comparison study demonstrated improved postoperative pain relief and functional outcomes at 1 and 6 weeks postoperatively with the addition of cement to intramedullary nailing of pathologic humeral shaft fractures. These results were compared to a historical cohort of uncemented intramedullary nails. There was no difference in perioperative complications, and no difference in pain or functional outcomes at 6 months postoperatively.
Two other studies included in the review were also retrospective studies, one of which included 39 patients and the other 208 patients. These both appeared to include lesions at the proximal, diaphyseal, and distal humerus. In the larger study (excluding endoprosthetic reconstruction), plate fixation (as compared to intramedullary fixation), had a higher failure rate. The other included study did not note a difference between these constructs.
Future studies should compare cemented and cementless constructs for fixation of pathologic humerus fractures, and evaluate pain, location of the lesion, functional outcomes, and mechanical failure rates of each construct.
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