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Meta-Analysis
. 2019 Nov 18;20(1):550.
doi: 10.1186/s12891-019-2936-y.

Comparison between minimally invasive plate osteosynthesis and open reduction-internal fixation for proximal humeral fractures: a meta-analysis based on 1050 individuals

Feilong Li  1 , Xuqiang Liu  1 , Fuqiang Wang  1 , Zhiping Gu  1 , Qianyuan Tao  1 , Cong Yao  1 , Xuwen Luo  1 , Tao Nie  2
Affiliations
Meta-Analysis

Comparison between minimally invasive plate osteosynthesis and open reduction-internal fixation for proximal humeral fractures: a meta-analysis based on 1050 individuals

Feilong Li et al. BMC Musculoskelet Disord. .

Abstract

Background: This meta-analysis aimed to compare the clinical outcomes and complications of minimally invasive plate osteosynthesis (MIPO) and open reduction-internal fixation (ORIF) in patients with proximal humeral fractures.

Methods: We searched PubMed, EMBASE, Ovid, and the Cochrane Library to identify all relevant studies from inception to April 2019. Cochrane Collaboration's Review Manage 5.3 was used for meta-analysis.

Results: Sixteen studies involving 1050 patients (464 patients in the MIPO group and 586 patients in the ORIF group) were finally included. According to the meta-analysis, MIPO was superior to ORIF in operation time, blood loss, postoperative pain, fracture union time, and constant score. However, MIPO was associated with more exposure to radiation and axillary nerve injury. No significant differences were found in length of hospital stays and complication except for axillary nerve injury.

Conclusion: The present evidence indicates that compared to ORIF, MIPO had advantages in functional outcomes, operation time, blood loss, postoperative pain, and fracture union time for the treatment of PHFs. However, the MIPO technique had a higher rate of axillary nerve injury and longer radiation time compared to ORIF.

Keywords: Meta-analysis; Minimally invasive plate osteosynthesis (MIPO); Open reduction–internal fixation (ORIF); Proximal humeral fractures.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of studies processed for inclusion
Fig. 2
Fig. 2
Risk of bias summary of all included randomized control trials. + represents yes; − represents no;? represents unclear
Fig. 3
Fig. 3
Forest plot for blood loss between the MIPO and ORIF groups. MIPO: minimally invasive plate osteosynthesis; ORIF: open reduction–internal fixation; OR: odds ratio; CI: confidence interval
Fig. 4
Fig. 4
Forest plot for operation time between the MIPO and ORIF groups. MIPO: minimally invasive plate osteosynthesis; ORIF: open reduction–internal fixation; OR: odds ratio; CI: confidence interval
Fig. 5
Fig. 5
Forest plot for radiation time between the MIPO and ORIF groups. MIPO: minimally invasive plate osteosynthesis; ORIF: open reduction–internal fixation; OR: odds ratio; CI: confidence interval
Fig. 6
Fig. 6
Forest plot for postoperative pain between the MIPO and ORIF groups. MIPO: minimally invasive plate osteosynthesis; ORIF: open reduction–internal fixation; OR: odds ratio; CI: confidence interval
Fig. 7
Fig. 7
Forest plot for union time between the MIPO and ORIF groups. MIPO: minimally invasive plate osteosynthesis; ORIF: open reduction–internal fixation; OR: odds ratio; CI: confidence interval
Fig. 8
Fig. 8
Forest plot for constant score between the MIPO and ORIF groups. MIPO: minimally invasive plate osteosynthesis; ORIF: open reduction–internal fixation; OR: odds ratio; CI: confidence interval
Fig. 9
Fig. 9
Funnel plot for publication bias. OR: odds ratio, SE: standard error
Fig. 10
Fig. 10
Funnel plot for publication bias. SE: standard error, SMD: standard mean difference
See this image and copyright information in PMC

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