Evidence map›Paper›PMID 37620629›Full record

ReviewJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2023

Intramedullary nailing versus cemented plate for treating metastatic pathological fracture of the proximal humerus: a comparison study and literature review.

Karl Wu, Ting Lin, Cheng-Han Lee

Open access · goldAbstract readReview
In one paragraph

Review in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Complication and revision risks of surgical treatment for proximal humerus metastases: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Pooled it
  3. Article
  4. Article
  5. Article
  6. Clinico-radiological outcomes of four-part proximal humerus fracture fixation with fibular strut graft augmentation.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Article
  7. Article
  8. Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 2 countries.

Karl WuDepartment of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan.
Ting LinDepartment of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Cheng-Han LeeDepartment of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., New Taipei City, 220, Taiwan (R.O.C.). kevinwooo@gmail.com.
Far Eastern Memorial Hospital · TWMinistry of Health and Welfare · KR

Funding

the FEMH grand (No. FEMH-2020-C-049)
6 · The paper itself

Abstract

backgroundPathological fracture of the humerus causes severe pain, limited use of the hand, and decreased quality of life. This study aimed to compare the outcomes of intramedullary nailing and locking plate in treating metastatic pathological fractures of the proximal humerus.

methodsThis retrospective comparison study included 45 patients (22 male, 23 female) with proximal humerus metastatic pathological fractures who underwent surgical treatment between 2011 and 2022. All data were collected from medical records and were analyzed retrospectively. Seventeen cases underwent intramedullary nailing plus cement augmentation, and 28 cases underwent locking plate plus cement augmentation. The main outcomes were pain relief, function scores, and complications.

resultsAmong 45 patients with mean age 61.7 ± 9.7 years, 23 (51.1%) had multiple bone metastases, and 28 (62.2%) were diagnosed with impending fractures. The nailing group had significantly lower blood loss [100 (60-200) versus 500 (350-600) ml, p < 0.001] and shorter hospital stay (8.4 ± 2.6 versus 12.3 ± 4.3 days, p < 0.001) than the plating group. Average follow-up time of the nailing group was 12 months and 16.5 months for the plating group. The nailing group had higher visual analog scale (VAS) scores than the plating group, indicating greater pain relief with nailing [7 (6-8) versus 6 (5-7), p = 0.01]. Musculoskeletal Tumor Society functional scores [28 (27-29) versus 27 (26.5-28.5), p = 0.23] were comparable between groups. No complications, local recurrence, or revision surgery were reported until the last follow-up in either group. However, one case in the plating group had a humeral head collapse and fragmentation without needing revision surgery.

conclusionsIntramedullary nailing with cement augmentation is a viable option for treating proximal humerus metastatic pathological fracture, providing rigid fixation and better pain relief resulting in earlier mobility to optimize functional outcomes. Less invasive procedure with less blood loss and shorter hospital stay also benefits patients. Level of evidence Level II. Trial registration statement Not applicable.

Indexed as

Fracture Fixation, IntramedullaryFractures, SpontaneousAgedBone CementsFemaleHumansHumerusMaleMiddle AgedQuality of LifeRetrospective StudiesBone CementsIntramedullary nailingMetastatic bone tumorPathological fractureProximal humerus

Identifiers

PMID37620629
PMCPMC10449752
OpenAlexW4386121796

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.