Intramedullary Nailing of Pathological Humerus Diaphyseal Fractures Without Cement Augmentation

Background and Objectives: The quality of life of patients decreases significantly after pathological long bone fractures. Therefore, rapid and effective treatment of these fractures is necessary in these patients with a low life expectancy. The aim of this study was to evaluate the results of intramedullary nailing in patients with pathological humeral diaphyseal fractures. Materials and Methods: Patients who underwent intramedullary nailing due to pathological humeral diaphyseal fractures between 2022 and 2025 were analyzed retrospectively. All patients were operated on using the same technique. Preoperative and postoperative complete blood count tests were performed to indirectly assess perioperative blood loss by evaluating changes in hemoglobin levels. The EQ-5D-5L (EuroQol Group-5 Dimensions-5 Levels) scale was used at the second, fourth, and eighth weeks postoperatively to assess the functional outcome of patients. Results: In total, 18 patients with a mean age of 64.6 years (range, 47–77 years) were included in the study. The most common primary diagnosis was multiple myeloma (n = 7, 38.9%). The primary diagnoses of two patients (11.1%) were unknown. An average decrease of 11% (range, 5.2–24.7) was observed in the postoperative hemoglobin values of the patients compared to the preoperative values. Radiographic fracture union was observed in all 12 evaluable patients with a follow-up longer than 3 months. The EQ-5D-5L scores improved significantly across the second, fourth, and eighth postoperative weeks in all five dimensions (Friedman tests, all p < 0.001). All pairwise comparisons remained significant after Bonferroni correction (adjusted p = 0.000023–0.005859). Conclusions: In this small, single-center case series, fracture union was observed in all 12 evaluable patients treated with minimally invasive intramedullary nailing without cement augmentation, and the EQ-5D-5L scores improved over the first eight postoperative weeks. These descriptive findings do not establish comparative benefit; controlled studies are needed to determine the relative outcomes of this approach.