Intralesional curettage, cement augmentation and fixation with Synthes Philos plate for pathological humeral fracture surgical technique
Subscribe to get full access to this operation and the extensive Shoulder & Elbow Surgery Atlas.
Learn the Intralesional curettage, cement augmentation and fixation with Synthes Philos plate for pathological humeral fracture surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Intralesional curettage, cement augmentation and fixation with Synthes Philos plate for pathological humeral fracture surgical procedure.
The humerus is the second most appendicular common site of osseous metastatic disease after the femur. Metastatic bone disease causes pain, swelling, fracture and subsequent dysfunction. The management of such patients needs to be pragmatic, balancing multiple conflicting patient and technical factors including but not limited to the age, fitness and willingness of a patient to have surgery, estimated prognosis, extent of osseous or visceral metastatic disease, severity of symptoms and dysfunction, impending or pathological fracture, curative or palliative intent.
There are multiple surgical options although optimal use of non-operative interventions should not be overlooked by orthopaedic oncologists.
The present case is a fairly typical presentation of a patient with multiple osseous sites of metastatic prostate carcinoma with a pathological humeral fracture and an impending femoral fracture, who, after discussion with his oncology team, underwent stabilisation of his humerus first to enable the use of crutches after femoral reconstruction. The use of cement augmented plate stabilisation was selected in favour of resection and endoprosthetic replacement as surgery was palliative (i.e. a non-curative intervention to alleviate pain & increase function) and because the bone destruction was minimal. You can read about the technique for proximal humeral endoprosthetic replacement here: https://www.orthoracle.com/library/proximal-humeral-replacement-mutars-reverse-geometry-shoulder-implantcast/
Jonathan Stevenson FRCS (Tr&Orth)
Author: Jonathan Stevenson FRCS (Tr & Orth).
Institution: Royal Orthopaedic Hospital, Birmingham,UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
- You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
- On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
- Your dashboard also will contain a record of the time you have spent logged onto and using the site.
- The timer suspends after 5 minutes though if there is no activity.
- When you restart you will resume at the same point in the module.
- Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
The pass mark is 75%.
- If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
Our content is designed for both Surgeons in independent practice and Surgeons in training.