Plating may be superior to intramedullary nailing in fixation of humeral shaft fractures .
Plate versus intramedullary nail fixation in the treatment of humeral shaft fractures: an updated meta-analysis
J Shoulder Elbow Surg. 2013 Mar;22(3):387-95. doi: 10.1016/j.jse.2012.06.007. Epub 2012 Sep 110 studies (randomized controlled trials (RCT) or quasi-RCTs) were included in this analysis which evaluated the use of plating and intramedullary nailing as a method of fixation in humeral shaft fractures. Overall, 439 patients were assessed all together in the included studies, with data available on nonunion, delayed union, postoperative infection, and reoperation rates at a minimum of 12 months postsurgically. Pooled results indicated that similar incidence of nonunion, delayed union and infection occurred between treatment methods. While initially reoperation rates were better with the use of plating, a sensitivity analysis found no difference between methods. Postoperative shoulder complications were less frequent with plate fixation.
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