ReviewJournal of clinical orthopaedics and trauma2025
A systematic review of the surgical management of mid-shaft humeral fractures: Antegrade versus Retrograde Intramedullary nailing.
Review in Journal of clinical orthopaedics and trauma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aims: The aim of this systematic review and meta-analysis was to establish which intramedullary nailing technique, antegrade or retrograde, was associated with superior operative and/or functional outcomes in the treatment of humeral shaft fractures. Methods: This SR was registered on the international prospective register of systematic reviews (PROSPERO) (CRD42022373170). The databases used to conduct the search for literature were Pubmed/Medline, Embase, Web of Science. References of all included studies were screened to identify papers not found in the initial database search.The inclusion criteria were; humeral shaft fractures treated with intramedullary nailing, direct comparison of antegrade and retrograde techniques, participants aged 16 and over, and outcomes of interest being reported. Exclusion criteria included pathological humerus fractures, humeral shaft fracture operative management for delayed, mal or non-union and studies with follow up time of less than 3 months. Results: This review included three studies resulting in the analysis of 216 patients in total. The only significant surgical outcome was that surgical time (minutes) was found to be significantly shorter for the antegrade nailing group. The narrative synthesis suggested that antegrade nailing is associated with shoulder symptoms to a greater degree than retrograde nailing is for elbow symptoms. Risk of bias analysis found that all three included studies were at moderate risk of bias. Conclusions: There is not enough evidence to suggest whether antegrade or retrograde nailing results in better surgical or functional outcomes in the treatment of humeral shaft fractures. Sufficiently powered multicentre studies will be required to identify evidence-based advantages and disadvantages of both antegrade and retrograde intramedullary humeral nailing. Level of evidence: 1 - systematic review and meta-analysis.
Indexed as
Identifiers
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.