Minimally Invasive Plating Osteosynthesis Technique versus Anterolateral Approach for Fixation of Humeral Mid-Shaft Fractures (Systematic Review/Meta-Analysis)

Abstract

Background In this study, we performed a meta-analysis to identify whether minimally invasive plate osteosynthesis (MIPO) was superior to conventional open reduction internal fixation for treating humeral shaft fracture. Methods A systematic literature search was conducted up to February 2020 in ScienceDirect, Springer, MEDLINE, and PubMed databases for relevant papers that compared the outcomes of MIPO with ORPF, such as open reduction with plate osteosynthesis (ORPO) and for treating humeral shaft fractures. Meta-analysis was performed with jamovi project (2019) (jamovi Version 1.0 Computer Software). Results According to the search strategy, six studies that covered 300 patients were enrolled, including three randomized controlled trials (RCTs), one prospective cohort trials, and two retrospective cohort trials. Our meta-analysis did not detect any significant difference between MIPO and ORPF 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. Conclusions From this study, we concluded that humeral shaft fractures could be effectively treated with the MIPO technique due to the advantages of shorter fracture union time and lower incidence of fracture nonunion and iatrogenic radial nerve palsies rather than the conventional open reduction and internal fixation technique.