Metastatic Disease of the Proximal Humerus

Purpose: To describe a hybrid fixation technique combining a photodynamic bone stabilization system with a proximal humerus locking plate for the management of complete pathologic proximal humerus fractures secondary to metastatic disease, and to highlight its potential advantages and limitations. Methods: We present a case of a 68-year-old male with metastatic prostate cancer who sustained a displaced pathologic proximal humerus fracture with metastatic extension from the epiphysis into the humeral diaphysis. He underwent intramedullary and extramedullary fixation using a photodynamic bone stabilization system and a proximal humerus locking plate. Surgical technique, intraoperative considerations, and postoperative outcomes were evaluated. Results: At 4-month follow-up, the patient demonstrated significant pain relief and improved functional outcomes. Radiographs confirmed maintenance of reduction and evidence of fracture healing. The hybrid construct provided immediate mechanical stability, enhanced screw fixation in compromised bone, and full-length intramedullary load-sharing support while minimizing imaging artifact and interference with adjuvant radiotherapy. Conclusion: Combined photodynamic bone stabilization system and proximal humerus locking plate stabilization represents a viable surgical option for selected pathologic proximal humerus fractures with extensive metastatic involvement. This hybrid approach offers improved stability and biological advantages over isolated fixation methods; however, concerns remain regarding implant durability, cost, and removal complexity. Further studies are needed to evaluate long-term outcomes and comparative effectiveness. Level of Evidence: Level V—Case Report, Technique Paper, Literature Review.