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http://www.orthojournalhms.org/volume5/manuscripts/ms17.htm
Pathologic Humerus Fracture
Reuben Gobezie MD, Brent A. Ponce MD, John Ready MD
DEPARTMENT OF ORTHOPAEDICS, BRIGHAM AND WOMEN'S HOSPITAL, BOSTON MA
Introduction
Bony lesions may result in pathologic fractures. These lesions, when not of mesenchymal origin, commonly include myeloma, lymphoma, and most commonly metastastic carcinoma. The axial skeleton is the third most common site of bony metastasis, after the lung and liver. Of the 1.2 million new cases of cancer each year in the United States, one half will metastasize to the skeleton1. The tumors most likely to metastasize to bone are prostate (32%), breast (22%), kidney (16%), lung and thyroid1.
Metastatic disease to the axial skeleton occurs much more frequently in the spine, pelvis, ribs, and lower extremities than in the humerus. Yet, metastasis to the humerus accounts for 20% of osseous metastasis. The humerus is the second most common site for long bone metastases, behind only the femur in its frequency of involvment. In multiple myeloma, the majority of patients have pathologic fractures at the time of diagnosis, and up to 30% of patients present with non-vertebral fractures2.
Metastasis to the long bones usually reflects an advanced disease state. It has been recommended that the majority of patients with metastatic bone tumors receive multidisciplinary care from a team including orthopaedic oncologists, radiotherapists, and oncologists.
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http://www.biomedcentral.com/1471-2474/8/70/abstract
Rare clinical experiences for surgical treatment of melanoma with osseous metastases in Taiwan
Kuo-Yuan Huang , Chrong-Reen Wang and Rong-Sen Yang
BMC Musculoskeletal Disorders 2007, 8:70 doi:10.1186/1471-2474-8-70 (Full Text)
Conclusions
Due to the high morbidity and poor survival of Taiwanese patients with osseous metastases of melanoma, surgical treatment should be directed towards pain relief and the prevention of skeletal debilitation in order to maintain their quality of life.
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http://www.bmj.com/cgi/content/full/332/7552/1227
BMJ 2006;332:1227-1228 (27 May),
Editorial
Orthopaedic procedures can help terminally ill patients and are underused
Wisam I Al-Hakim, clinical research fellow, bone tumour unit
(wisam2410@hotmail.com), Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP
Jacub M Jagiello, clinical research fellow, bone tumour unit, Ken Mannan, specialist registrar, Tim W Briggs, consultant orthopaedic surgeon
Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP
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