SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Open plate fixation 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 20 papers, 1 of them a synthesis that pooled it.
What it found
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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
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Humeral shaft fracture: systematic review of non-operative and operative treatment.Archives of orthopaedic and trauma surgery · 2023Pooled it
- The radial nerve bridging plate technique for humeral shaft fractures: an approach facilitating plate removal without impeding fracture union - a case series.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Distribution of putative SSI risk factors in adults undergoing open reduction and fixation of long bone fracture.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Observational
- Anatomical safety and clinical feasibility of percutaneous supraclavicular humeral nailing via the Neviaser portal: a combined cadaveric and clinical study.International orthopaedics · 2026Article
- Rigid locked antegrade versus retrograde intramedullary nailing in treating acute humeral shaft fractures: a systematic review with meta-analysis.EFORT open reviews · 2026Article
- Lateral decubitus positioning with arthroscopic shoulder distractor for humeral intramedullary nail.OTA international : the open access journal of orthopaedic trauma · 2025Article
- [Conservative and operative treatment options for humeral shaft fractures].Unfallchirurgie (Heidelberg, Germany) · 2025Review
- A systematic review of the surgical management of mid-shaft humeral fractures: Antegrade versus Retrograde Intramedullary nailing.Journal of clinical orthopaedics and trauma · 2025Review
- Outcomes of Intramedullary Nailing Versus Plate Fixation of Humerus Shaft Fractures: A Single-Center Retrospective Study.Advances in orthopedics · 2025Article
- The effect of plate location on radial nerve palsy recovery time associated with humeral shaft fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Anterograde Intramedullary Nailing without Bone Grafting for Humeral Shaft Nonunion Associated with Early Exploration of Secondary Radial Nerve Palsy: A Case Report.Neurology international · 2024Article
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- Unchanged incidence but change in treatment trends from 1996 to 2018: 23,718 humeral shaft fractures from the Danish National Patient Registry.Acta orthopaedica · 2023Article
- Humerus shaft fractures, approaches and management.Journal of clinical orthopaedics and trauma · 2023Review
- Distal locking technique affects the rate of iatrogenic radial nerve palsy in intramedullary nailing of humeral shaft fractures.Archives of orthopaedic and trauma surgery · 2023Article
- Outcome and complication comparison for intramedullary nail versus open reduction internal fixation in humeral diaphyseal fractures for 2800 matched patient pairs utilizing the Nationwide Readmissions Database.Journal of orthopaedic surgery and research · 2023Article
- Routine fixation of humeral shaft fractures is cost-effective : cost-utility analysis of 215 patients at a mean of five years following nonoperative management.Bone & joint open · 2022Article
- Complications in humeral shaft fractures - non-union, iatrogenic radial nerve palsy, and postoperative infection: a systematic review and meta-analysis.EFORT open reviews · 2022Review
- WHICH SURGICAL TREATMENT IS PREFERABLE IN HUMERAL DIAPHYSEAL FRACTURES? A SYSTEMATIC REVIEW.Orthopedic reviews · 2022Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis meta-analysis compares open reduction and internal fixation with a plate (ORIF) versus nailing for humeral shaft fractures with regard to union, complications, general quality of life and shoulder/elbow function.
methodsPubMed/Medline/Embase/CENTRAL/CINAHL was searched for observational studies and randomised clinical trials (RCT). Effect estimates were pooled across studies using random effects models. Results were presented as weighted odds ratio (OR) or risk difference (RD) with corresponding 95% confidence interval (95% CI). Subgroup analysis was performed stratified for study design (RCTs and observational studies).
resultsEighteen observational studies (4906 patients) and ten RCT's (525 patients) were included. The pooled effect estimates of observational studies were similar to those obtained from RCT's. More patients treated with nailing required re-intervention (RD 2%; OR 2.0, 95% CI 1.0-3.8) with shoulder impingement being the most predominant indication (17%). Temporary radial nerve palsy secondary to operation occurred less frequently in the nailing group (RD 2%; OR 0.4, 95% CI 0.3-0.6). Notably, all but one of the radial nerve palsies resolved spontaneously in each groups. Nailing leads to a faster time to union (mean difference - 1.9 weeks, 95% CI - 2.9 to - 0.9), lower infection rate (RD 2%; OR 0.5, 95% CI 0.3-0.7) and shorter operation duration (mean difference - 26 min, 95% CI - 37 to - 14). No differences were found regarding non-union, general quality of life, functional shoulder scores, and total upper extremity scores.
conclusionNailing carries a lower risk of infection, postoperative radial nerve palsy, has a shorter operation duration and possibly a shorter time to union. Shoulder impingement requiring re-intervention, however, is an inherent disadvantage of nail fixation. Notably, absolute differences are small and almost all patients with radial nerve palsy recovered spontaneously. Satisfactory results can be achieved with both treatment modalities.
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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.