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Fragility of statistically significant findings from randomized clinical trials of surgical treatment of humeral shaft fractures:A systematic review

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World Journal of Orthopedics 2022年第9期13卷 825-836页

作者： Stephen Craig Morris Anirudh K Gowd Avinesh Agarwalla Wesley P Phipatanakul Nirav H Amin Joseph N Liu Department of Orthopaedic Surgery Loma Linda UniversityLoma LindaCA 92354United States Department of Orthopaedic Surgery Wake Forest University Baptist Medical CenterWinston-SalemNC 27157United States Department of Orthopaedic Surgery Westchester Medical CenterValhallaNY 10595United States Department of Orthopaedic Surgery Premier Orthopaedic and Trauma SpecialistsPomonaCA 91767United States Department of Orthopedic Surgery USC Epstein Family Center for Sports MedicineLos AngelesCA 90089United States

BACKGROUND Despite recent meta-analyses of randomized controlled trials(RCTs),there remains no consensus regarding the preferred surgical treatment for humeral shaft *** fragility index(FI)is an emerging tool used to evaluate the robustness of RCTs by quantifying the number of participants in a study group that would need to switch outcomes in order to reverse the study *** To investigate the fragility index of randomized control trials assessing outcomes of operative fixation in proximal humerus *** We completed a systematic review of RCTs evaluating the surgical treatment of humeral shaft *** criteria included:articles published in English;patients randomized and allotted in 1:1 ratio to 2 parallel arms;and dichotomous outcome *** FI was calculated for total complications,each complication individually,and secondary surgeries using the Fisher exact test,as previously *** Fifteen RCTs were included in the analysis comparing open reduction plate osteosynthesis with dynamic compression plate or locking compression plate,intramedullary nail,and minimally invasive plate *** median FI was 0 for all parameters *** individual outcomes,the FI was 0 for 81/91(89%)of *** FI exceeded the number lost to follow up in only 2/91(2%)*** The FI shows that data from RCTs regarding operative treatment of humeral shaft fractures are fragile and does not demonstrate superiority of any particular surgical technique.

关键词： humerus fracture Open reduction internal fixation Intramedullary nail Fragility index Complications Fragility index

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Assessment of some demographic risk factors associated with diaphyseal humeral fractures among Nigerians

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Burns & Trauma 2015年第1期3卷 35-40页

作者： Vitalis Chukwuma Ezeuko Agbonluai Richard Ehimigbai Ehijele Loveth Esechie Department of Anatomy School of Basic Medical SciencesCollege of Medical SciencesUniversity of BeninBenin CityEdoNigeria

Background:The epidemiology of fractures of the humeral shaft has received little attention in *** study was aimed at investigating the possible risk factors associated with diaphyseal humeral fractures among ***:The study was carried out retrospectively at the Department of Medical Records,National Orthopaedic Hospital,Igbobi,Lagos State,Nigeria,between 2007 and *** notes and plain films of X-ray from a total number of 206 patients of ages from birth to one hundred years(0–100 years),comprising of 140 males and 66 females,were used for the *** analyses were done using Statistical Package for Social Sciences(SPSS)version 16.0 and presented in bar *** frequencies were reported as *** differences in frequencies were compared using chi-square ***:The results showed that the percentage frequency of diaphyseal humeral fractures was significantly higher(Pfractures was road traffic accident followed by ***:The major causes of diaphyseal humeral fractures are road traffic accidents and *** diaphyseal humeral fracture is an issue of harsh economic consequences,adequate measures should be taken by all the parties involved,especially government agencies,to address this menace in term of road maintenance and general well-being of the ***,since it was observed that different regions of the bones of interest present diverse characteristics with respect to associated risk factors,it is recommended that such studies as this should be region-based rather than whole-bone based.

关键词： humerus fracture Diaphyseal Nigerian Risk factor

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