The Importance of Closed Reduction and Internal Fixation done with Intramedullary Implants in Pathological Fractures – A Case Series

Introduction: Pathological fractures resulting from metastatic bone involvement, multiple myeloma (MM), and atypical femoral fractures present complex therapeutic challenges. Intramedullary (IM) nailing offers a biomechanically stable solution that facilitates early mobilization and enhances functional outcomes. This case series aims to evaluate the clinical and radiological results of IM fixation in pathological fractures, emphasizing pain relief and early functional outcomes. Case Series: We report a series of five patients with pathological fractures of long bones who underwent IM nailing, including cases of carcinoma breast, MM, hepatocellular carcinoma, and large B-cell lymphoma involvement. The cohort encompassed the geriatric age group and fracture locations, predominantly involving the femur and humerus. Surgical management utilized long IM nails and locked humeral nails. Results demonstrated significant pain reduction, early weight-bearing capability, and satisfactory union rates, with a low incidence of complications. Conclusion: IM nailing represents an effective and dependable approach for stabilizing pathological long bone fractures, promoting rapid symptomatic improvement and functional recovery. This series substantiates the role of fixation as a cornerstone in the surgical management of pathological fractures, providing valuable insights into fixation techniques and patient outcomes.