Minimally Invasive Plating Osteosynthesis in the Treatment of Humeral Shaft Fractures: A Meta-Analysis.
BACKGROUND
Whether minimally invasive plating osteosynthesis (MIPO) or other operative interventions is superior in the treatment of humeral shaft fractures remains controversial. Therefore, we conducted a meta-analysis to quantitatively compare the clinical outcomes of MIPO and other operative interventions in the treatment of humeral shaft fractures.


METHODS
Pubmed, Embase, and Web of Science were systematically searched to identify all available studies comparing clinical outcomes between patients receiving MIPO and other operative interventions. The weight mean difference (WMD) was pooled to compare the operative time, union time, University of California, Los Angeles (UCLA) score, and Mayo elbow performance index (MEPI).The risk ratio (RR) was pooled to compare the union rate, and incidence of complications. Pooled estimates were calculated by using a fixed-effects model or a randomized-effects model, according to the heterogeneity among studies.


RESULTS
Nine studies were included in this meta-analysis. Our results suggest that both MIPO and other operative interventions can achieve similar union time, UCLA score, MEPI, and union rate. However, MIPO is associated with better outcomes including shorter operation time, and lower incidence of radial nerve injury.


CONCLUSIONS
Evidence from this meta-analysis demonstrated that, MIPO is effective but safer than other operative interventions in the treatment of humeral shaft fracture. However, due to the potential limitations in this meta-analysis, randomized controlled trials with larger sample sizes using appropriate blinding methods are needed to confirm these findings.
a Department of Orthopedic Traumatology , Beijing Jishuitan Hospital , China.
Quan
Q
Zhang
a Department of Orthopedic Traumatology , Beijing Jishuitan Hospital , China.
Ning
N
Sun
a Department of Orthopedic Traumatology , Beijing Jishuitan Hospital , China.
Qiang
Q
Huang
a Department of Orthopedic Traumatology , Beijing Jishuitan Hospital , China.
Shiwen
S
Zhu
a Department of Orthopedic Traumatology , Beijing Jishuitan Hospital , China.
Xinbao
X
Wu
D001860:Bone Plates; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D063305:Organ Dysfunction Scores; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
humeral shaft fractures; meta-analysis; minimally invasive plating osteosynthesis