SynthesisJournal of orthopaedic surgery and research2015
Meta-analysis of locking plate versus intramedullary nail for treatment of proximal humeral fractures.
Synthesis in Journal of orthopaedic surgery and research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 6 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Interventions for treating proximal humeral fractures in adults.The Cochrane database of systematic reviews · 2022Pooled it
- Effect of intramedullary nail and locking plate in the treatment of proximal humerus fracture: an update systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2019Pooled it
- Intramedullary nail versus locking plate for treatment of proximal humeral fractures: A meta-analysis based on 1384 individuals.The Journal of international medical research · 2018Pooled it
- Locking plates versus intramedullary nails in the management of displaced proximal humeral fractures: a systematic review and meta-analysis.International orthopaedics · 2018Pooled it
- Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis and Open Reduction Internal Fixation on Proximal Humeral Fracture in Elder Patients: A Systematic Review and Meta-Analysis.BioMed research international · 2017Pooled it
- Pooled it
- Efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly.Clinical interventions in aging · 2017Trial
- A rotator cuff sparing deltopectoral approach to intramedullary nail of humeral fractures.JSES international · 2026Article
- Review
- Intramedullary versus locking plate fixation for proximal humerus fractures: indications and technical considerations.JSES reviews, reports, and techniques · 2024Review
- Review
- The application of a dual-lead locking screw could enhance the reduction and fixation stability of the proximal humerus fractures: a biomechanical evaluation.Frontiers in surgery · 2024Article
- Treatment of Metaphyseal Defects in Plated Proximal Humerus Fractures with a New Augmentation Technique-A Biomechanical Cadaveric Study.Medicina (Kaunas, Lithuania) · 2023Article
- Intramedullary Nail for Treatment of Proximal Humeral Fracture: A Credible Fixation in Comminuted Calcar.Orthopaedic surgery · 2023Article
- The Efficacy of Platelet-Rich Plasma Augmentation in Microfracture Surgery Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Comparison of intramedullary nail and plate osteosynthesis in humerus surgical neck fracture.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023Article
- The Role of Intramedullary Nailing for Proximal Humerus Fractures: What Works and What Does Not.Current reviews in musculoskeletal medicine · 2023Review
- Surgical management of 2- or 3-part proximal humeral fractures: comparison of plate, nail and K-wires.Musculoskeletal surgery · 2022Article
- ANTEGRADE NAILING VERSUS LOCKING PLATE OF 2-AND 3-PART PROXIMAL HUMERUS FRACTURES.Acta ortopedica brasileira · 2022Article
- Complication rate after operative treatment of three- and four-part fractures of the proximal humerus: locking plate osteosynthesis versus proximal humeral nail.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis meta-analysis compared the clinical outcomes of locking plate with intramedullary nail in the treatment of displaced proximal humeral fractures.
methodsWe searched PubMed, Embase, and the Cochrane databases for studies comparing locking plate and intramedullary nail treatment of displaced two-, three-, or four-part proximal humeral fractures. The quality of the studies was assessed, and meta-analysis was performed using the Cochrane Collaboration's REVMAN 5.1 software.
resultsA total of 615 patients from eight studies were included in this meta-analysis (348 fractures treated with locking plate and 267 with intramedullary nail). Similar Constant scores were observed between the locking plate and intramedullary nail both in randomized controlled trials (RCTs) (mean difference (MD) = 2.12, 95% confidence interval (CI), -2.54 to 6.79, P = 0.37) and observational studies (MD = -1.93, 95% CI, -4.95 to 1.09, P = 0.21). Only one RCT provided American Shoulder and Elbow Surgeons Standardized scores indicating that the locking plate was better than the intramedullary nail (MD = 7.20, 95% CI, 1.29-13.11, P = 0.02). The total complication rate did not specifically favor the locking plate or intramedullary nail both in the RCTs (risk ratio (RR), 2.44; 95% CI, 0.35-16.78; P = 0.37) and observational studies (RR, 1.01; 95% CI, 0.72-1.43; P = 0.94).
conclusionsIn the existing literature, limited evidence suggests that the locking plate and intramedullary nail are both valuable options for the treatment of proximal humeral fractures. Because of the observed heterogeneity and variance between the subgroups, more RCT are needed to be able to definitively recommend a locking plate or intramedullary nail for specific fracture patterns.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.