Plate versus intramedullary nail fixation in the treatment of humeral shaft fractures: an updated meta-analysis

Ouyang, Hui; Xiong, Jun; Peng, Xiang; Cui, Zhuang; Chen, Liguang; Yu, Bin

doi:10.1016/j.jse.2012.06.007

Cited by 112 publications

(86 citation statements)

References 28 publications

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“…In literature there is no evidence which suggests a higher percentage of infection in patients treated with this technique when compared with patients treated with other surgical techniques. The use of bent nails for fixation of diaphyseal fractures is debatable and there are studies showing that external insertion of the nail at the cuff footprint may be a iatrogenic condition [19].…”

Section: Discussionmentioning

confidence: 99%

Humeral shaft fractures treated with antegrade intramedullary nailing: What are the consequences for the rotator cuff?

Verdano

Pellegrini

Schiavi

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to investigate the clinical and sonographic impact on the rotator cuff (RC) of the use of the anterolateral approach for nailing. Clinical assessment using the Constant score, simple shoulder test and through shoulder examination tests was carried out. The sonographic study investigated the integrity of the RC. Results Mean score on Constant's scale was 78.21 points, with most patients achieving a good result (79 % obtained more than 65 points). One patient had a limited functional outcome (Constant's score of 49 points). The sonographic findings described for supraspinatus tendon were a partial ruptures of less than 30 mm in three patients and a complete tendon rupture in one case.Conclusions The results of this study suggest that the use of the anterolateral approach for antegrade humeral nailing ensures a good functional result with no significant clinicalsonographic impact on the rotator cuff and a satisfactory long term clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Humeral shaft fractures treated with antegrade intramedullary nailing: What are the consequences for the rotator cuff?

Verdano

Pellegrini

Schiavi

et al. 2013

International Orthopaedics (SICOT)

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“…The increased blood loss and operative complications like radial nerve palsy, superficial infections and deep infections have motivated surgeons to look for other alternative surgical techniques to treat and fix these fractures. Closed reduction and internal fixation with intramedullary nails have been studied extensively by a meta-analysis by Ouyang et.al [7] . According to their meta-analysis, nailing of humerus shaft fractures leads to a high incidence of shoulder related complications and that further effects the final outcome of patients in the long term.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

Int. J. Orthop. Sci.

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Background: 2 to 3% of all traumatic fractures in adults encountered by orthopaedic surgeons are humerus fractures. Operative management for these fractures has now gained popularity among surgeons to allow patients an early recovery and return to premorbid conditions. We compared the two commonly used implants for treating humerus shaft fractures, that is, locking compression plates and intramedullary nails in terms of complications associated and range of movements. Materials and methods: 40 patients were allotted into 2 groups, with 20 undergoing treatment with locking compression plates and 20 undergoing intramedullary nailing. The 2 groups were comparable when pre-operative demographics were analysed. Post-operative follow up showed the following results. Results: Axillary nerve injuries were noted in 4 out of the 20 patients in the nailing group and radial nerve palsy was note in 1 patient in the plating group after surgery. 2 cases of superficial wound infection and 1 case of deep wound infection were recorded in the plating group. 1 patient in each group were found to have delayed union. A significantly higher incidence of shoulder stiffness was recorded in the intramedullary nailing group. A significant difference in the DASH score was recorded, in favour of the plating group. This could be attributed to the pain free movements at shoulder joint. A significant difference in the Rodrigues Merchan outcome was seen, in favour of the plating group, with 70% patients having achieved good to excellent outcome, as opposed to 25% in the nailing group. A higher incidence of poor outcomes was seen in the nailing group due to shoulder related complications. Conclusion: We concluded that Open reduction and internal fixation with locking compression plates gave a better outcome to patients when followed up after surgery as compared to closed reduction and internal fixation with interlocking nails, primarily due to the shoulder related complications associated with intramedullary nailing.

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“…1,2 The distribution is bimodal, and they occur more commonly in the third decade of life in males and the seventh decade in females. [1][2][3] A majority of humeral shaft fractures can be treated successfully using non-operative methods such as hanging cast, functional brace, velpeau dressing, coaptation splint and abduction cast. 2,[4][5][6] In some cases, conservative methods are not sufficient.…”

Section: Introductionmentioning

confidence: 99%

“…2,4,7 Some surgeons opt for surgery even for simple humeral shaft fractures to avoid the risk of non-union and allow for early mobilisation and rapid return to work. 1,3,[7][8][9][10][11][12] Intramedullary nailing is considered the gold standard treatment for shaft fractures of long bones. 1,5,13 Although plate and screw fixation has traditionally been the preferred method for humeral shaft fractures, inflatable intramedullary nail is another option for surgical management of humeral shaft fractures, which has the advantages of easy application, minimum soft tissue injury, shortening the surgery time and less exposure to radiation.…”

Section: Introductionmentioning

confidence: 99%

“…1,5,13 Although plate and screw fixation has traditionally been the preferred method for humeral shaft fractures, inflatable intramedullary nail is another option for surgical management of humeral shaft fractures, which has the advantages of easy application, minimum soft tissue injury, shortening the surgery time and less exposure to radiation. 1,3,7,9,10,[13][14][15][16][17] The hydraulically inflatable intramedullary nail consists of an expandable stainless steel tube with four reinforcement bars connected by thin folded stainless steel membranes with a conical distal end. 6,10,13,16 Normal saline is injected into the hollow inner core of the nail under pressure through a proximal valve to expand it and increase its effective diameter (Fig.…”

Section: Introductionmentioning

confidence: 99%

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