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Meta-Analysis
. 2019 Aug 30;14(1):285.
doi: 10.1186/s13018-019-1345-0.

Effect of intramedullary nail and locking plate in the treatment of proximal humerus fracture: an update systematic review and meta-analysis

Xiaoqing Shi  1 , Hao Liu  1 , Runlin Xing  1 , Wei Mei  1 , Li Zhang  1 , Liang Ding  1 , Zhengquan Huang  1 , Peimin Wang  2
Affiliations
Meta-Analysis

Effect of intramedullary nail and locking plate in the treatment of proximal humerus fracture: an update systematic review and meta-analysis

Xiaoqing Shi et al. J Orthop Surg Res. .

Abstract

Background: To evaluate the effect of intramedullary nail and locking plate in the treatment of proximal humerus fracture (PHF).

Methods: China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Wan-fang database, Chinese Biomedicine Database (CBM), PubMed, EMBASE, Web of Science, and Cochrane Library were searched until July 2018. The eligible references all show that the control group uses locking plates to treat PHF, while the experimental group uses intramedullary nails to do that. Two reviewers independently retrieved and extracted the data. Reviewer Manager 5.3 was used for statistical analysis.

Results: Thirty-eight retrospective studies were referred in this study which involves 2699 patients. Meta-analysis results show that the intramedullary nails in the treatment of proximal humeral fractures are superior to locking plates in terms of intraoperative blood loss, operative time, fracture healing time, postoperative complications, and postoperative infection. But there is no significance in constant, neck angle, VAS, external rotation, antexion, intorsion pronation, abduction, NEER, osteonecrosis, additional surgery, impingement syndrome, delayed union, screw penetration, and screw back-out.

Conclusions: The intramedullary nail is superior to locking plate in reducing the total complication, intraoperative blood loss, operative time, postoperative fracture healing time and postoperative humeral head necrosis rate of PHF. Due to the limitations in this meta-analysis, more large-scale, multicenter, and rigorous designed RCTs should be conducted to confirm our findings.

Trial registration: PROSPERO CRD42019120508.

Keywords: Internal fixation; Intramedullary nail; Locking plate; Meta-analysis; Proximal humeral fracture.

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Conflict of interest statement

The authors declare that they have no competing interests

Figures

Fig. 1
Fig. 1
Flow chart of studies selecting
Fig. 2
Fig. 2
The forest plot for Intraoperative blood
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Fig. 3
The forest plot for operation time
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Fig. 4
The forest plot for fracture healing time
Fig. 5
Fig. 5
The forest plot for overall complication
Fig. 6
Fig. 6
Funnel plot
See this image and copyright information in PMC

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