Meta-analysis of the outcomes of intramedullary nailing and plate fixation of humeral shaft fractures

Liu, Guodong; Qing-gang, Zhang; Ou, Shan; Zhou, Lei; Fei, Jun; Chen, Hongwei; Guo, Nan; Gu, Jianwen

doi:10.1016/j.ijsu.2013.08.002

Cited by 34 publications

(26 citation statements)

References 17 publications

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“…[7] Recently, the outcomes of conventional plate osteosynthesis (CPO) have been considered to be the gold standard surgical treatment. [8,9] However, open reduction and plate fixation still reveals complications such as malunion, nonunion, iatrogenic radial nerve injury, and deep infection. [10,11] …”

Section: Introductionmentioning

confidence: 99%

Comparison of minimally invasive plate osteosynthesis and conventional plate osteosynthesis for humeral shaft fracture

Liu

Gao

et al. 2016

Medicine

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Background:The objective of this meta-analysis was to compare the efficacy and safety of minimally invasive plate osteosynthesis (MIPO) and conventional plate osteosynthesis (CPO) for humeral shaft fracture.Methods:Potential academic articles were identified from the Cochrane Library, Medline (1966–2016.3), PubMed (1966–2016.3), Embase (1980–2016.3), and ScienceDirect (1966–2016.3). Gray studies were identified from the references of the included literature. Randomized controlled trials (RCTs) and non-RCT involving MIPO and CPO for humeral shaft fracture were included. Two independent reviewers performed independent data abstraction. I2 statistic was used to assess heterogeneity. Fixed or random effects model was used for meta-analysis.Results:Two RCTs and 3 non-RCTs met the inclusion criteria. There was a lower incidence of iatrogenic radial nerve palsy in patients with MIPO (P = 0.006). There was no statistically significant difference in in the risk of developing nonunion, delay union, malformation, screw loosening, infection, operation time, UCLA, and MEPS function score between the 2 groups.Conclusion:MIPO decreased incidence of iatrogenic radial nerve palsy and is an efficacy and safety technique for humeral shaft fracture. Due to the limited quality and data of the evidence currently available, more high-quality RCTs are required.

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Section: Introductionmentioning

confidence: 99%

Comparison of minimally invasive plate osteosynthesis and conventional plate osteosynthesis for humeral shaft fracture

Liu

Gao

et al. 2016

Medicine

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“…11 Therefore, the efficacy of plate fixation and IMN is still debated. 12 Many randomized, controlled trials have reported dynamic compression plate (DCP) fixation and IMN fixation of humeral shaft fractures. 1,4,8,[12][13][14][15][16][17][18] However, it is unclear whether one method is more effective than the other.…”

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confidence: 99%

Management of Humeral Shaft Fractures With Intramedullary Interlocking Nail Versus Locking Compression Plate

Fan¹,

Li²,

Zhang³

et al. 2015

Orthopedics

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Surgical fixation of humeral shaft fractures generally involves plating or nailing. It is unclear whether one method is more effective than the other. The aim of this study was to compare the results of the intramedullary nail and locking compression plate for the treatment of humeral shaft fractures. A total of 60 patients with humeral shaft fractures were randomized to undergo surgery with an intramedullary interlocking nail (n=30) or locking compression plate (n=30). The outcome was assessed in terms of intraoperative blood loss, operative time, hospital stay, union time, union rate, functional outcome, and incidence of complications. Functional outcome was assessed using the Constant score and the American Shoulder and Elbow Surgeons (ASES) score. Intraoperative blood loss, operative time, and hospital stay in group A (intramedullary interlocking nail) were significantly lower than those in group B (locking compression plate). No statistically significant difference was found regarding the union rate, mean Constant score, and mean ASES score between the groups. The average union time was found to be significantly lower for the intramedullary interlocking nail compared with the locking compression plate. The incidence of complications such as radial nerve palsy was found to be higher with the locking compression plate compared with the intramedullary interlocking nail. The intramedullary interlocking nail can be considered a better surgical option for the management of humeral shaft fractures because it offers decreased intraoperative blood loss; shorter operative times, hospital stays, and union times; and a lower incidence of serious complications such as radial nerve palsy.

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“…Changulani et al found that infection rates after plate osteosynthesis are four times higher than with IMN [32]. A recent meta-analysis confirmed that there is a significant correlation between plate osteosynthesis and infection, although this difference has not been reported in other publications [20,30,33,34].…”

Section: Discussionmentioning

confidence: 95%

Intramedullary nailing of humeral shaft fractures: failure analysis of a single centre series

Metsemakers

Wijnen

Sermon³

et al. 2015

Arch Orthop Trauma Surg

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Meta-analysis of the outcomes of intramedullary nailing and plate fixation of humeral shaft fractures

Abstract: In general, the effect size of intramedullary nailing may be comparable to that of plate fixation in the terms of nonunion, postoperative infections, radial nerve paralysis. The only slightly difference was identified in the event of delayed healing rate.

Cited by 34 publications

References 17 publications

Comparison of minimally invasive plate osteosynthesis and conventional plate osteosynthesis for humeral shaft fracture

Comparison of minimally invasive plate osteosynthesis and conventional plate osteosynthesis for humeral shaft fracture

Management of Humeral Shaft Fractures With Intramedullary Interlocking Nail Versus Locking Compression Plate

Intramedullary nailing of humeral shaft fractures: failure analysis of a single centre series

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