Dynamic compression plating versus locked intramedullary nailing for humeral shaft fractures: a meta-analysis of RCTs and nonrandomized studies

14 studies (n=727; 6 RCTs; 2 quasi-randomized trials; 2 prospective comparative studies and 4 retrospective comparative studies) comparing dynamic compression plating versus locked intramedullary nailing in the treatment of humeral shaft fractures were included in this review. The purpose of this study was to compare these two surgical approaches with respect to rates of complication and revision. Meta-analysis of outcomes indicated that although the incidences of infection and nerve palsy were significantly higher in the plate group compared to the nail group, the total incidence of complications (including shoulder impairment) significantly favoured the plate group. There was no significant difference between groups with respect to rates of nonunion and revision surgery.