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Clinical effect of operative vs nonoperative treatment on humeral shaft fractures:Systematic review and meta-analysis of clinical trials

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World Journal of Orthopedics 2024年第8期15卷 783-795页

作者： Yang Li Yi Luo Jing Peng Jun Fan Xiao-Tao Long Department of Traumatic Orthopedics Chongqing General HospitalChongqing UniversityChongqing 401147China Department of Orthopedics Bishan Hospital of ChongqingChongqing 402760China

BACKGROUND Whether operation is superior to non-operation for humeral shaft fracture remains *** hypothesized that operation could decrease the nonunion and reintervention rates and increase the functional *** To compare the clinical efficacy between operative and nonoperative approaches for humeral shaft *** We searched the PubMed,Web of Science,ScienceDirect,and Cochrane databases from 1990 to December 2023 for clinical trials and cohort studies comparing the effects of operative and conservative methods on humeral shaft *** investigators independently extracted data from the eligible studies,and the other two assessed the methodological quality of each *** quality of the included studies was assessed using the Cochrane risk bias or Newcastle-Ottawa *** nonunion,reintervention and the overall complications and functional scores were pooled and analyzed using Review Manager software(version 5.3).RESULTS A total of four randomized control trials and 13 cohort studies were included,with 1285 and 1346 patients in the operative and nonoperative groups,*** in the operative group were treated with a plate or nail,whereas those in the conservative group were managed with splint or functional *** studies were assessed as having a high risk of bias,and the other 13 were of a low risk of bias according to the Newcastle-Ottawa Scale or Cochrane risk bias *** operative group had a significantly decreased rate of nonunion[odds ratio(OR)0.30;95%CI:0.23 to 0.40,reintervention(OR:0.33;95%CI:0.24 to 0.47),and overall complications(OR:0.62;95%CI:0.49 to 0.78)].The pooled effect of the Disabilities of Arm,Shoulder,and Hand score showed a significant difference at 3[mean difference(MD)-8.26;95%CI:-13.60 to-2.92],6(MD:-6.72;95%CI:-11.34 to-2.10),and 12 months(MD:-2.55;95%CI:-4.36 to-0.74).The pooled effect of Visual Analog Scale scores and the Constant-Murley score did not significantly differ between

关键词： humeral shaft fracture Operation Nonoperation Brace Systematic review

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Radial nerve recovery following closed nailing of humeral shaft fractures without radial nerve exploration: A retrospective study

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World Journal of Clinical Cases 2021年第27期9卷 8044-8050页

作者： Kuei-Lin Yeh Chen-Kun Liaw Tai-Yin Wu Chung-Pei Chen Department of Orthopedics Shin Kong Wu-Ho Su Memorial HospitalTaipei City 111Taiwan Department of Orthopedics School of MedicineCollege of MedicineTaipei Medical UniversityTaipei City 11031Taiwan Department of Orthopedics Shuang Ho HospitalTaipei Medical UniversityNew Taipei City 23561Taiwan Graduate Institute of Biomedical Optomechatronics College of Biomedical EngineeringResearch Center of Biomedical DeviceTaipei Medical UniversityTaipei City 11301Taiwan Department of Family Medicine Zhongxing BranchTaipei City HospitalTaipei City 10341Taiwan Institute of Epidemiology and Preventive Medicine National Taiwan UniversityTaipei City 10055Taiwan National Taipei University of Nursing and Health Science Taipei City 11219Taiwan Department of Orthopedics Cathay General HospitalNew Taipei City 221Taiwan

BACKGROUND Radial nerve palsy due to humeral shaft fracture is the most common peripheral nerve injury associated with long bone *** antegrade nailing surgical technique is becoming popular for the fixation of these fractures with minimal *** analyzed nerve recovery in patients with humeral shaft fracture and radial nerve palsy treated with humeral nail fixation without nerve *** To assess the radial nerve recovery rate and time from humeral shaft fracture with surgical treatment using close *** We retrospectively collected data of patients who underwent undergone surgical nail fixation for humeral shaft fractures between October 1,2016,and March 31,***,we analyzed the primary or secondary radial nerve palsy recovery rate and radial nerve motor function recovery *** The study included 70 patients who underwent surgical treatment for closed-or Gustilo type I open humeral shaft fractures using a nail fixation technique without radial nerve *** patients suffered from primary(n=5)and secondary(n=5)radial nerve palsy.A 100%radial nerve recovery rate was *** mean recovery time was 4.3 *** The study results indicate full recovery of radial nerve palsies from humeral shaft fracture using close nailing *** need not be concerned about the occurrence of permanent nerve palsies.

关键词： humeral shaft fracture Radial nerve palsy Close nailing fixation Nerve exploration

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Biomechanical Study of the Fixation Strength of Anteromedial Plating for humeral shaft fractures

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Chinese Medical Journal 2016年第15期129卷 1850-1855页

作者： Yin-Feng Zheng Jun-Lin Zhou Xiao-Hong Wang Lei Shan Yang Liu Department of Orthopedics Beijing Chaoyang Hospital Capital Medical University Beijing 100020 China Technical Research Department Beijing Medical Implant Engineering Research Center Beijing 100095 China Technical Research Department Beijing Engineering Laboratory of Functional Medical Materials and Devices Beijing 100095 China Technical Research Department Beijing Naton Technology Group Co. Ltd. Beijing 100095 China

Background： Open reduction and internal fixation with plate and screws are the gold standard for the surgical treatment of humeral shaft fractures, this study was to compare the mechanical properties ofanteromedial, anterolateral, and posterior plating for humeral shaft fractures. Methods： A distal third humeral shaft fracture model was constructed using fourth-generation sawbones （#3404, composite bone）. A total of 24 sawbones with a distal third humeral shaft fracture was randomly divided into three Groups： A, B, and C （n = 8 in each group） for anteromedial, anterolateral, and posterior plating, respectively. All sawbones were subjected to horizontal torsional fatigue tests, horizontal torsional and axial compressive fatigue tests, four-point bending fatigue tests in anteroposterior （AP） and mediolateral （ML） directions and horizontal torsional destructive tests. Results： In the horizontal torsional fatigue tests, the mean torsional angle amplitude in Groups A, B, and C were 6.12°, 6.53°, and 6.81°. In horizontal torsional and axial compressive fatigue tests, the mean torsional angle amplitude in Groups A, B, and C were 5.66°, 5.67°, and 6.36°. The mean plate displacement amplitude was 0.05 mm, 0.08 mm, and 0.10 mm. Group A was smaller than Group C （P 〈 0.05）. In AP four-point bending fatigue tests, the mean plate displacement amplitude was 0.16 ram, 0.13 ram, and 0.20 mm. Group B was smaller than Group C （P 〈 0.05）. In ML lbur-point bending fatigue tests, the mean plate displacement amplitude were 0.16 mm, 0.19 ram, and 0.17 ram. In horizontal torsional destructive tests, the mean torsional rigidity in Groups A, B, and C was 0.82, 0.75, and 0.76 N·m/deg. The yielding torsional angle was 24.50°, 25.70°, and 23.86°. The mean yielding torque was 18.46, 18.05. and 16.83 N·m, respectively. Conclusions： Anteromedial plating was superior to anterolateral or posterior plating in all mechanical tests except in AP four-point bending fatigue tests compared to the anterolate

关键词： Anteromedial Plating Biomechanics Compressive Plate fracture Model humeral shaft fracture

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