Antegrade intramedullary nailing for pathological ulnar fracture due to metastatic lung adenocarcinoma: A case report

Metastatic bone disease in long bones frequently causes pathological fractures, significantly impairing patients' quality of life. Effective management requires balancing pain control, early mobilization, and durable stabilization. Intramedullary nailing is widely recognized as a minimally invasive surgical option that provides biomechanical stability and reduces operative morbidity. Although extensively studied in femoral, tibial, and humeral metastatic lesions, its application for ulna metastatic fractures is considerably less common and less documented.This case report describes a 56-year-old male with stage IV lung adenocarcinoma presenting with an ulna pathological fracture. After initial conservative management failed, antegrade intramedullary nailing was performed. The procedure provided solid mechanical stabilization and effective pain relief, allowing full functional recovery of the limb postoperatively.This report adds to limited data supporting IMN use for metastatic forearm fractures, highlighting its role in pain alleviation, mechanical stability, and quality-of-life preservation. Future studies and additional case documentation are needed to optimize surgical strategies in this rare but challenging clinical scenario.