{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:29:46Z","timestamp":1791847786304,"version":"4.3.4"},"reference-count":76,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Intramedullary nailing (IMN) is a common option for managing impending or pathologic fractures of the humerus secondary to metastatic disease. We sought to assess the (1) early complications, (2) failure rates and mechanisms, and (3) functional outcomes. A systematic review using the PubMed, Embase, and Cochrane databases was performed. Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses guidelines were followed. The study was registered on PROSERO (CRD42023406905). The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for quality assessment. Studies describing postoperative outcomes of patients with impending or pathologic fractures of the humerus treated with IMN were included. Implant failure was classified into mechanical and nonmechanical causes. Functional outcomes were assessed via the Musculoskeletal Tumor Society (MSTS) score. Overall, 41 studies comprising 1431 patients were included. Early complications occurred in 5.5% of patients, with 2.8% of patients having systemic complications. The overall implant failure rate was 4.9%, and the mean MSTS score at the last follow\u2010up was 79.9%. IMN was associated with good postoperative functional outcomes and low implant failure rates. Systemic complications were the most common type of early complication, and tumor progression was the main cause of implant failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.27975","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T06:54:25Z","timestamp":1730962465000},"page":"932-941","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Postoperative Complications of Intramedullary Nailing for Impending and Pathologic Fractures of the Humerus Due to Bone Metastases\u2014A Systematic Review of the Literature"],"prefix":"10.1002","volume":"131","author":[{"given":"James I.","family":"Griggers","sequence":"first","affiliation":[{"name":"Medical College of Georgia Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Alcantar","sequence":"additional","affiliation":[{"name":"Medical College of Georgia Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3352-6362","authenticated-orcid":false,"given":"Marcos R.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Division of Orthopaedic Oncology, Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0681-9004","authenticated-orcid":false,"given":"Santiago A.","family":"Lozano\u2010Calderon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Division of Orthopaedic Oncology, Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016022"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13193-021-01426-1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2009.05429.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-008-0418-0"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0748-7983(96)92450-6"},{"key":"e_1_2_7_7_1","first-page":"357","article-title":"Impending Pathologic Fractures From Metastatic Malignancy: Evaluation and Management","volume":"35","author":"Harrington K. D.","year":"1986","journal-title":"Instructional Course Lectures"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198912000-00027"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-009-0833-y"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.09.018"},{"issue":"5","key":"e_1_2_7_11_1","first-page":"429","article-title":"The Long Gamma Nail for Stabilisation of Existing and Impending Pathological Fractures of the Femur: An Analysis of 48 Cases","volume":"70","author":"Moholkar K.","year":"2004","journal-title":"Acta Orthopaedica Belgica"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-008-0343-4"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.02.124"},{"key":"e_1_2_7_14_1","first-page":"49","article-title":"Latest Developments in Surgical and Minimally Invasive Treatment of Metastatic Bone Disease","volume":"2","author":"Kistler B. J.","year":"2014","journal-title":"Ortho\u2010Oncology"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-008-0540-0"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12306-020-00668-6"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-001-0307-3"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2023.04.023"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-22-01159"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.38.BJO-2022-0092.R1"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199301000-00035"},{"issue":"3","key":"e_1_2_7_22_1","first-page":"77","article-title":"Surgical Fixation of Pathologic Fractures: An Evaluation of Evolving Treatment Methods","volume":"63","author":"Hunt K. J.","year":"2006","journal-title":"Bulletin (Hospital for Joint Diseases (New York, N.Y.))"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199002000-00036"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/COC.0000000000000937"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000002104"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1530\/EOR-22-0001"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2021.100358"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2020.02.025"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbo.2017.10.012"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2019.05.021"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2656-1"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2019.08.022"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2016.8.4.458"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2011.06.019"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-1814-1"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-010-1172-6"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.08.015"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-006-9257-8"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-002-0428-1"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453679909011250"},{"issue":"6","key":"e_1_2_7_41_1","first-page":"891","article-title":"Interlocking Intramedullary Nailing of Pathological Fractures of the Shaft of the Humerus","volume":"78","author":"Redmond B. J.","year":"1996","journal-title":"Journal of Bone & Joint Surgery"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(96)00056-3"},{"issue":"1","key":"e_1_2_7_43_1","first-page":"23","article-title":"Locked Intramedullary Nailing of Humeral Shaft Fractures. Implant Design, Surgical Technique, and Clinical Results","volume":"76","author":"Ingman A.","year":"1994","journal-title":"Journal of Bone and Joint Surgery. British volume"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20200619-08"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-198801000-00011"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1177\/230949900301100108"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000165857.12676.00"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-5069-8"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-021-02250-1"},{"issue":"5","key":"e_1_2_7_50_1","first-page":"51","article-title":"Treatment of Pathologic Fractures of the Humerus With Seidel Nailing","volume":"350","author":"Tome J.","year":"1998","journal-title":"Clinical Orthopaedics and Related Research"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7800-3-5"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.01067"},{"issue":"1","key":"e_1_2_7_53_1","first-page":"100","article-title":"Proximal Humerus Fractures Treatment in Adult Patients With Bone Metastasis","volume":"26","author":"Rovere G.","year":"2022","journal-title":"European Review for Medical and Pharmacological Sciences"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2022.100427"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181692132"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.55095\/achot2014\/050"},{"key":"e_1_2_7_57_1","first-page":"415","article-title":"Intramedullary Nailing in the Treatment of Pathological Fractures of the Humerus","volume":"45","author":"Ulloa D.","year":"2001","journal-title":"REVISTA DE ORTOPEDIA Y TRAUMATOLOGI\u0301A"},{"key":"e_1_2_7_58_1","first-page":"410","article-title":"Intramedullary Nailing in the Treatment of Pathological Fractures of the Humerus","volume":"45","author":"Stern L.\u2010D.","year":"2001","journal-title":"REVISTA DE ORTOPEDIA Y TRAUMATOLOGI\u0301A"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15143601"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.22.00232"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16020443"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.23.00159"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.11.035"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.1177\/10711007231198516"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000000463"},{"key":"e_1_2_7_66_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318195c50c"},{"key":"e_1_2_7_67_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-015-2296-5"},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200006000-00008"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.07.039"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-022-04665-1"},{"key":"e_1_2_7_71_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199908000-00025"},{"key":"e_1_2_7_72_1","doi-asserted-by":"publisher","DOI":"10.1302\/1863-2548.13.190016"},{"key":"e_1_2_7_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2018.03.009"},{"key":"e_1_2_7_74_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol29050284"},{"key":"e_1_2_7_75_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-020-02734-y"},{"key":"e_1_2_7_76_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-021-03136-4"},{"key":"e_1_2_7_77_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1105745"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.27975","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T16:46:13Z","timestamp":1763225173000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.27975"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,7]]},"references-count":76,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/jso.27975"],"URL":"https:\/\/doi.org\/10.1002\/jso.27975","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,7]]},"assertion":[{"value":"2024-07-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}