SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
MIPO versus nailing for humeral shaft fractures: a meta-analysis and systematic review of randomised clinical trials and observational studies.
Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis 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
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Cement augmentation for trochanteric femur fractures: A meta-analysis of randomized clinical trials and observational studies.PloS one · 2021Pooled it
- Cost-Effectiveness of Surgery Versus Functional Bracing for Humeral Shaft Fractures in Adults: A Prespecified Economic Evaluation of the Finnish Shaft of the Humerus (FISH) Trial.The Journal of bone and joint surgery. American volume · 2026Trial
- MIPO versus ORIF with long proximal humerus locking plate for metadiaphyseal proximal humeral fracture.Journal of orthopaedic surgery and research · 2026Article
- Intraoperative evaluation of rotational alignment in minimally invasive plate osteosynthesis for humeral shaft fractures using combined fluoroscopic and endoscopic assistance: surgical technique, clinical outcomes, and literature review.Archives of orthopaedic and trauma surgery · 2026Review
- [Conservative and operative treatment options for humeral shaft fractures].Unfallchirurgie (Heidelberg, Germany) · 2025Review
- Outcomes of Intramedullary Nailing Versus Plate Fixation of Humerus Shaft Fractures: A Single-Center Retrospective Study.Advances in orthopedics · 2025Article
- Lateral minimally invasive plate osteosynthesis (MIPO) with long PHILOS for proximal metaphyseal-diaphyseal humeral fracture: surgical techniques and a clinical series.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Minimally invasive lateral plating for diaphyseal fractures with extension into the proximal humerus and its implications for the deltoid muscle and its distal insertion: functional analysis and MR-imaging.BMC musculoskeletal disorders · 2023Article
- Humerus shaft fractures, approaches and management.Journal of clinical orthopaedics and trauma · 2023Review
- Treatment of humeral shaft fractures with different treatment methods: a network meta-analysis of randomized controlled trials.BMC musculoskeletal disorders · 2023Article
- Recovery and functional outcome after radial nerve palsy in adults with a humeral shaft fracture: a multicenter prospective case series.JSES international · 2023Article
- Intraoperative imaging in hip arthroplasty: a meta-analysis and systematic review of randomized controlled trials and observational studies.Arthroplasty (London, England) · 2023Review
- Prevalence and risk factors for pseudarthrosis in humeral shaft fractures treated by minimally invasive plate osteosynthesis: A 10-year review.Shoulder & elbow · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThere is no consensus on the optimal operative technique for humeral shaft fractures. This meta-analysis aims to compare minimal-invasive plate osteosynthesis (MIPO) with nail fixation for humeral shaft fractures regarding healing, complications and functional results.
methodsPubMed/Medline/Embase/CENTRAL/CINAHL were searched for randomized clinical trials (RCT) and observational studies comparing MIPO with nailing for humeral shaft fractures. Effect estimates were pooled across studies using random effects models and presented as weighted odds ratio (OR), risk difference (RD), mean difference (MD) and standardized mean difference (SMD) with corresponding 95% confidence interval (95%CI). Analyses were repeated stratified by study design (RCTs and observational studies).
resultsA total of 2 RCTs (87 patients) and 5 observational studies (595 patients) were included. The effects estimated in observational studies and RCTs were similar in direction and magnitude for all outcomes except operation duration. MIPO has a lower risk for non-union (RD 7%; OR 0.2, 95% CI 0.1-0.5) and re-intervention (RD 13%; OR 0.3, 95% CI 0.1-0.8). Functional shoulder (SMD 1.0, 95% CI 0.2-1.8) and elbow scores (SMD 0.4, 95% CI 0-0.8) were better among patients treated with MIPO. The risk for radial nerve palsy following surgery was equal (RD 2%; OR 0.6, 95% CI 0.3-1.2) and nerve function recovered spontaneously in all patients in both groups. No difference was detected with regard to infection, time to union and operation duration.
conclusionMIPO has a considerable lower risk for non-union and re-intervention, leads to better shoulder function and, to a lesser extent, better elbow function compared to nailing. Although nailing appears to be a viable option, the evidence suggests that MIPO should be the preferred treatment of choice. The learning curve of minimal-invasive plating should, however, be taken into account when interpreting these results.
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What OpenQuestion holds
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.