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Morbidity and mortality of surgically treated pathologic humerus fractures compared to native humerus fractures

Journal of Shoulder and Elbow Surgery Nov 21, 2020

Amen TB, Varady NH, Birir A, et al. - This study was undertaken to ascertain short-term complication profiles after surgical treatment of pathologic humerus fractures and evaluate how these complications compared to more commonly studied native humerus fractures. Researchers distinguished 30,866 patients who had undergone surgical treatment for either pathologic (n=449) or native humerus fractures (n=30,417) from 2007-2017 applying the National Surgical Quality Improvement Program database. They determined 30-day postoperative complication profiles and compared between the two groups using chi-squared analyses. In comparison with native humerus fractures, patients with pathologic humerus fractures had significantly higher complication rates after surgical treatment, implying that guidelines and treatment algorithms for native humerus fractures may not be generalizable for those of pathologic origin. For preoperative patient counseling, these data have significant implications and may be applied to negotiate higher reimbursement rates for these patients given significantly higher morbidity and mortality than was previously described in the literature. The results of this study demonstrated that postoperatively, orthopedic surgeons should closely monitor individuals with pathologic humerus fractures for deep vein thrombosis, renal complications, and pulmonary complications, utilize blood sparing techniques and employ a multidisciplinary approach to help manage and prevent a more heterogeneous profile of postsurgical complications.

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