title: Case-Match Controlled Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing for the Stabilization of Humeral Shaft Fractures.
abstract: OBJECTIVE
  To compare the risk of major complications after either minimally invasive plate osteosynthesis (MIPO) or intramedullary nailing (IMN) of humeral shaft fractures.
  
  
  METHODS
  Retrospective, case-match controlled study.
  
  
  METHODS
  A major metropolitan tertiary referral trauma center in Australia.
  
  
  METHODS
  Thirty patients with fractures of the humeral shaft.
  
  
  METHODS
  Either MIPO or IMN were performed on 15 patients each with traumatic humeral shaft fractures.
  
  
  METHODS
  The cumulative risk of 3 major complications associated with these procedures: nonunion, infection, and iatrogenic radial nerve injury.
  
  
  RESULTS
  An overall major complication rate of 53% was observed in the patients treated with IMN; one complication (7%) was identified in those managed with humeral MIPO, a nonunion. Complications after IMN included 4 patients (27%) with nonunion, 3 patients (20%) with iatrogenic radial nerve injuries, and 1 patient (7%) with a wound infection. Statistical analysis revealed a significant between-group difference (P = 0.01) in the cumulative rate of major complications. When each of these complications was considered independently, no statistically significant difference was demonstrated.
  
  
  CONCLUSIONS
  This study suggests that humeral MIPO results in a significantly lower pooled major complication rate than that of IMN, and it should therefore be considered an attractive alternative to IMN in those patients requiring surgical stabilization of a traumatic humeral shaft fracture.
  
  
  METHODS
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors: *Department of Orthopaedic Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia; †Musculoskeletal Research Unit, Central Queensland University, Rockhampton, Australia; ‡School of Medicine, University of Queensland, Brisbane, Australia; and §Orthopaedic Research Centre of Australia, Brisbane, Australia.
authors: Gareth
authors: G
authors: Davies
authors: Gerald
authors: G
authors: Yeo
authors: Mahendrakumar
authors: M
authors: Meta
authors: David
authors: D
authors: Miller
authors: Erik
authors: E
authors: Hohmann
authors: Kevin
authors: K
authors: Tetsworth
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001860:Bone Plates; D016022:Case-Control Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D006810:Humeral Fractures / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome