2024 AAOS Annual Meeting: Conservative management with functional bracing versus various surgical fixation techniques for humeral shaft fractures: a network meta-analysis

21 randomized controlled trials (1203 patients) comparing conservative management to surgical fixation techniques for humeral shaft fractures were included in this network meta-analysis. Outcomes of interest included time to union, rates of nonunion, rates of malunion, rates of reoperation, and the incidence of iatrogenic radial nerve injury, superficial infection, and secondary surgical intervention. Patients were either treated with functional bracing (FB; n=190), open reduction and internal fixation (ORIF), minimally invasive plate osteosynthesis, or intramedullary nailing through antegrade (aIMN) or retrograde (rIMN) approaches. FB had higher odds for nonunion and longer time to union than ORIF, MIPO or aIMN but was associated with lower odds of iatrogenic radial nerve injury and superficial infection than both ORIF and MIPO.