ArticleJournal of orthopaedic surgery and research2023
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.
Article in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- InSafeLOCK intramedullary nailing versus plate fixation for humeral diaphyseal fractures: a retrospective cohort study with 24-month outcomes.BMC surgery · 2026Article
- Nonunion and Postoperative Complications Associated With Intramedullary Nailing Versus Plate Fixation of Humeral Shaft Fractures.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Comparative outcomes of operative treatment for two and three-part proximal humerus fractures with or without ipsilateral shaft fractures and head-split patterns: intramedullary nail versus open reduction internal fixation.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionOpen reduction internal fixation (ORIF) and intramedullary nail fixation (IMN) are the predominant repair methods for operative treatment of humeral diaphyseal fractures; however, the optimal method is not fully elucidated. The purpose of this study was to analyze whether IMN or ORIF humeral diaphyseal surgeries result in a significantly higher prevalence of adverse outcomes and whether these outcomes were age dependent. We hypothesize there is no difference in reoperation rates and complications between IMN and ORIF for humeral diaphyseal fractures.
methodsData collected from 2015 to 2017 from the Nationwide Readmissions Database were evaluated to compare the prevalence of six adverse outcomes: radial nerve palsy, infections, nonunion, malunion, delayed healing, and revisions. Patients treated for a primary humeral diaphyseal fracture with either IMN or ORIF were matched and compared (n = 2,804 pairs). Patients with metastatic cancer were excluded.
resultsFollowing an ORIF procedure, there was a greater odds of undergoing revision surgery (p = 0.03) or developing at least one of the complications of interest (p = 0.03). In the age-stratified analysis, no significant differences were identified in the prevalence of adverse outcomes between the IMN and ORIF cohorts in the 0-19, 20-39, and 40-59 age groups. Patients who were 60 + had 1.89 times the odds of experiencing at least one complication and 2.04 times the odds of undergoing a revision after an ORIF procedure versus an IMN procedure (p = 0.03 for both). DISCUSSION: IMN and ORIF for humeral diaphyseal fractures are comparable in regard to complications revision rates in patients under the age of 60. Meanwhile, patients 60 + years show a statistically significant increase in the odds of undergoing revision surgery or experiencing complications following an ORIF. Since IMN appears to be more beneficial to older patients, being 60 + years old should be considered when determining fracture repair techniques for patients presenting with primary humeral diaphyseal fractures. LEVEL OF EVIDENCE III:
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