A meta-analysis of plate fixation versus intramedullary nailing for humeral shaft fractures.

Abstract

There is a lack of consensus on whether intramedullary nailing (IMN) or plating is superior for humeral shaft fractures. In this meta-analysis, we combined data from PubMed, the Excerpta Medica Database (Embase), the Cochrane Library, and the Chinese National Knowledge Infrastructure (CNKI) (all to Dec 31, 2011). Six randomized controlled trials (RCTs) and two quasi-RCTs including 384 participants were selected and assessed by use of an 11-item scale. Heterogeneity was assessed by use of the standard chi-squared test and the I (2) statistic. The results indicated that two primary outcomes (total number of complications and functional measurement) were significantly better for plate fixation. Significantly lower risk of delayed-union, restriction, impingement of the shoulder, shoulder pain, and re-operation were found for the plating group, which suggested that plating is superior to IMN for humeral shaft fractures. Level II; meta-analysis of RCTs and quasi-RCTs; treatment study.