title: Minimally invasive plate osteosynthesis vs conventional fixation techniques for surgically treated humeral shaft fractures: a meta-analysis.
abstract: BACKGROUND
  In this study, we performed a meta-analysis to identify whether minimally invasive plate osteosynthesis (MIPO) was superior to conventional fixation techniques (CFT) for treating humeral shaft fractures.
  
  
  METHODS
  A systematic literature search was conducted up to February 2016 in ScienceDirect, Springer, MEDLINE, and PubMed databases for relevant papers that compared the outcomes of MIPO with CFT, such as open reduction with plate osteosynthesis (ORPO) and intramedullary nail (IMN) for treating humeral shaft fractures. Meta-analysis was performed with Review Manager 5.0 software.
  
  
  RESULTS
  According to the search strategy, eight studies that covered 391 patients were enrolled, including four randomized controlled trials (RCTs), two prospective cohort trials, and two retrospective cohort trials. Our meta-analysis did not detect any significant difference between MIPO and CFT (IMN and ORPO) in terms of operative time, fracture union rate, and fracture union time. However, MIPO has a less rate of complications and iatrogenic radial nerve palsy than that of ORPO and higher adjacent joint function scores than those of IMN (p < 0.05).
  
  
  CONCLUSIONS
  Based on the present evidence, this meta-analysis suggested that MIPO was a better choice for treating humeral shaft fractures than CFT. However, more high-quality randomized trials are still needed to further confirm this conclusion in the future.
authors.affiliation: Department of Orthopaedics, the Second Affiliated Hospital of Jiaxing University, 1518 Huancheng North Road, Jiaxing, China.
authors.forename: Xuqi
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Clinical Laboratory, the Second Affiliated Hospital of Jiaxing University, 1518 Huancheng North Road, Jiaxing, China.
authors.forename: Siqi
authors.initials: S
authors.lastname: Xu
authors.affiliation: Department of Orthopaedics, the Second Affiliated Hospital of Jiaxing University, 1518 Huancheng North Road, Jiaxing, China.
authors.forename: Huigen
authors.initials: H
authors.lastname: Lu
authors.affiliation: Department of Orthopaedics, the Second Affiliated Hospital of Jiaxing University, 1518 Huancheng North Road, Jiaxing, China.
authors.forename: Bao
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, the Second Affiliated Hospital of Jiaxing University, 1518 Huancheng North Road, Jiaxing, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Orthopaedics, the Second Affiliated Hospital of Jiaxing University, 1518 Huancheng North Road, Jiaxing, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Orthopaedics, the Second Affiliated Hospital of Jiaxing University, 1518 Huancheng North Road, Jiaxing, China.
authors.forename: Jiaping
authors.initials: J
authors.lastname: Dai
authors.affiliation: Department of Orthopaedics, the Second Affiliated Hospital of Jiaxing University, 1518 Huancheng North Road, Jiaxing, China.
authors.forename: Zhongwei
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, the Second Affiliated Hospital of Jiaxing University, 1518 Huancheng North Road, Jiaxing, China. jxhuxuqi@163.com.
authors.forename: Suiliang
authors.initials: S
authors.lastname: Gong
mesh_terms: D001858:Bone Nails; D001860:Bone Plates; D004812:Epidemiologic Methods; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D006810:Humeral Fractures / Q000503:physiopathology / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D000070799:Open Fracture Reduction / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D020425:Radial Neuropathy / Q000209:etiology; D016896:Treatment Outcome
keywords: Humeral shaft fracture; Intramedullary nail; Meta-analysis; Minimally invasive plate osteosynthesis; Open reduction with plate osteosynthesis