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Review
. 2016 May 11;11(1):59.
doi: 10.1186/s13018-016-0394-x.

Minimally invasive plate osteosynthesis vs conventional fixation techniques for surgically treated humeral shaft fractures: a meta-analysis

Xuqi Hu  1 , Siqi Xu  2 , Huigen Lu  1 , Bao Chen  1 , Xiao Zhou  1 , Xiaojun He  1 , Jiaping Dai  1 , Zhongwei Zhang  1 , Suiliang Gong  3
Affiliations
Review

Minimally invasive plate osteosynthesis vs conventional fixation techniques for surgically treated humeral shaft fractures: a meta-analysis

Xuqi Hu et al. J Orthop Surg Res. .

Abstract

Background: In this study, we performed a meta-analysis to identify whether minimally invasive plate osteosynthesis (MIPO) was superior to conventional fixation techniques (CFT) for treating humeral shaft fractures.

Methods: A systematic literature search was conducted up to February 2016 in ScienceDirect, Springer, MEDLINE, and PubMed databases for relevant papers that compared the outcomes of MIPO with CFT, such as open reduction with plate osteosynthesis (ORPO) and intramedullary nail (IMN) for treating humeral shaft fractures. Meta-analysis was performed with Review Manager 5.0 software.

Results: According to the search strategy, eight studies that covered 391 patients were enrolled, including four randomized controlled trials (RCTs), two prospective cohort trials, and two retrospective cohort trials. Our meta-analysis did not detect any significant difference between MIPO and CFT (IMN and ORPO) in terms of operative time, fracture union rate, and fracture union time. However, MIPO has a less rate of complications and iatrogenic radial nerve palsy than that of ORPO and higher adjacent joint function scores than those of IMN (p < 0.05).

Conclusions: Based on the present evidence, this meta-analysis suggested that MIPO was a better choice for treating humeral shaft fractures than CFT. However, more high-quality randomized trials are still needed to further confirm this conclusion in the future.

Keywords: Humeral shaft fracture; Intramedullary nail; Meta-analysis; Minimally invasive plate osteosynthesis; Open reduction with plate osteosynthesis.

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Figures

Fig. 1
Fig. 1
Flowchart of the articles included in this meta-analysis
Fig. 2
Fig. 2
Forest plot illustrating the UCLA score and MEPS of meta-analysis MIPO with CFT (ORPO and IMN) in humeral shaft fractures
Fig. 3
Fig. 3
Forest plot illustrating complications and iatrogenic radial nerve palsy of meta-analysis MIPO with CFT (ORPO and IMN) in humeral shaft fractures
Fig. 4
Fig. 4
Forest plot illustrating union rate and union time of meta-analysis MIPO with CFT (ORPO and IMN) in humeral shaft fractures
Fig. 5
Fig. 5
Forest plot illustrating operative time and radiation exposure time of meta-analysis MIPO with CFT (ORPO and IMN) in humeral shaft fractures
See this image and copyright information in PMC

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