title: Dynamic compression plating versus locked intramedullary nailing for humeral shaft fractures: a meta-analysis of RCTs and nonrandomized studies.
abstract: OBJECTIVE
  There is no consensus regarding treatment of humeral shaft fracture. In this meta-analysis, we pooled studies to compare dynamic compression plate with locked intramedullary nail for this injury.
  
  
  METHODS
  PubMed, MEDLINE, and Embase databases were searched for relevant studies published between January 1995 and July 2012. Evaluated endpoints were method-related complications and revision. Study quality was assessed, and meta-analyses were analyzed using the Cochrane Collaboration's REVMAN 5.0 software.
  
  
  RESULTS
  Fourteen randomized controlled (RCTs) and nonrandomized studies with 727 patients were analyzed. There was a significantly higher risk of total method-related complications and shoulder impairment resulting from locked intramedullary nailing compared with dynamic compression plating. Plating was significantly associated with a higher risk of infection and postoperative nerve palsy. There was no significant difference with respect to nonunion and revision rate.
  
  
  CONCLUSIONS
  Nailing may cause more method-related complications and shoulder impartment than plating, although it may lead to a lower risk of infection and postoperative nerve palsy. In the future, more high-quality RCTs are required to enhance these conclusions.
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, JiaoTong University, No. 600 YiShan Road, 200233 Shanghai, China.
authors.forename: Jiezhi
authors.initials: J
authors.lastname: Dai
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, JiaoTong University, No. 600 YiShan Road, 200233 Shanghai, China. Electronic address: chaiyimin@gmail.com.
authors.forename: Yimin
authors.initials: Y
authors.lastname: Chai
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, JiaoTong University, No. 600 YiShan Road, 200233 Shanghai, China.
authors.forename: Chunyang
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, JiaoTong University, No. 600 YiShan Road, 200233 Shanghai, China.
authors.forename: Gen
authors.initials: G
authors.lastname: Wen
mesh_terms: D001860:Bone Plates; D002986:Clinical Trials as Topic; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D011312:Pressure; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome