{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:25:32Z","timestamp":1793319932221,"version":"4.5.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Clinically, metastatic pathological fractures of the humeral shaft remain a challenging issue. Plate osteosynthesis and intramedullary nailing are common fixation methods; however, the optimal strategy remains debated, especially in patients with limited life expectancy where surgical goals include rapid pain relief, functional recovery, and fewer reoperations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 27 patients with metastatic humeral shaft fractures treated surgically during 2009\u20132019. Patients were grouped by plate osteosynthesis (n = 17) and antegrade intramedullary nailing (n = 10), and operative time, intraoperative blood loss, pain relief (visual analog scale), functional outcomes (Musculoskeletal Tumor Society scoring system), postoperative survival, complications were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intramedullary nailing was associated with significantly less blood loss (298 \u00b1 61 vs 557 \u00b1 124\u00a0mL,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and better MSTS score (22.1 \u00b1 3.34 vs 17.41 \u00b1 6.2,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.05) compared with plating, whereas postoperative pain relief was comparable. Postoperative survival did not differ significantly between the two groups. Complication rates did not different significantly, although implant failure\u2013mediated reoperation occurred only in the plate group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both fixation methods achieved pain relief and functional improvement. However, intramedullary nailing demonstrated distinct advantages, reducing surgical morbidity, minimizing reoperation and superior functional outcomes which will benefit metastatic patients with low life expectancy. Overall, these results support intramedullary nailing as a reliable first-line option for most humeral shaft pathological fractures, whereas plate fixation may be reserved for proximal or distal lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536251401233","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T04:47:54Z","timestamp":1764218874000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Pathological fracture of the humeral shaft: Antegrade intramedullary nailing versus plate osteosynthesis with bone defect cementation"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9828-0067","authenticated-orcid":false,"given":"Tse-Pu","family":"Huang","sequence":"first","affiliation":[{"name":"Tri-Service General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao-Tung","family":"Tsai","sequence":"additional","affiliation":[{"name":"Tri-Service General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.08.015"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198602000-00032"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2011.06.019"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-009-0833-y"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0748-7983(96)92450-6"},{"key":"e_1_3_6_7_2","first-page":"149","article-title":"Treatment of pathological humerus-shaft tumoral fractures with rigid static interlocking intramedullary nail\u201422 years of experience","volume":"54","author":"Diogo LM","year":"2019","unstructured":"Diogo LM, Filipe A, R\u00faben F, et al. Treatment of pathological humerus-shaft tumoral fractures with rigid static interlocking intramedullary nail\u201422 years of experience. Rev Bras Ortop 2019; 54: 149\u2013155.","journal-title":"Rev Bras Ortop"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/230949900301100108"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-013-0497-8"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0082075"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199606000-00012"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-006-9257-8"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-010-1172-6"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B8.26194"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.1.000008"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1807-59322006000400007"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-009-0813-2"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2012.06.007"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000599"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-011-0871-1"}],"container-title":["Journal of Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536251401233","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10225536251401233","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536251401233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:32:51Z","timestamp":1777678371000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10225536251401233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1177\/10225536251401233"],"URL":"https:\/\/doi.org\/10.1177\/10225536251401233","relation":{},"ISSN":["1022-5536","2309-4990"],"issn-type":[{"value":"1022-5536","type":"print"},{"value":"2309-4990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"article-number":"10225536251401233"}}