Intramedullary nailing for pathological fractures of the proximal humerus caused by multiple myeloma: A case report and review of literature

Figure 1 Plasma cell myeloma was diagnosed following bone marrow aspirate and trephine.

Figure 2 Preoperative X-ray films and magnetic resonance imaging. A, B: X-ray films (A, B) of the left shoulder revealed only a comminuted fracture and degenerative changes in the upper left humerus; C, D: Multiple soft tissue masses around the fracture presented as hypointensity and isointensity on T1 weighted (T1-W) images (C) and hybrid hyperintensity on T2-W images (D).

Figure 3 Bone scan showed high metabolism of 18-F fluorodeoxyglucose in multiple ribs, the fifth lumbar vertebra (L5), and left proximal humerus.

Figure 4 Postoperative X-ray films. A, B: Postoperative X-ray films of the left shoulder; C-H: Follow-up at 6 mo (C, D), 15 mo (E, F) and 40 mo (G, H) after surgery. The proximal humerus fracture eventually healed.