Antegrade locked intramedullary nailing versus dynamic compression plating for humeral shaft fractures in adults: a meta-analysis of randomized controlled trials

There are two generally accepted techniques, antegrade locked intramedullary nailing and dynamic compression plating, for the treatment of humeral shaft fractures in adults. However, which technique is superior remains controversial. The aim of this meta-analysis is to compare the clinical outcomes of the two techniques and to present the best evidence currently available. We conducted an electronic search of using databases including the Cochrane registry of clinical trials, Medline, and Embase. Studies were selected, and data were extracted independently by two investigators. Four trials were found, which matched the inclusion criteria. Statistical heterogeneity was not detected among these included trials. The available evidence demonstrated that dynamic compression plating may lead to fewer complications and shoulder impairments but may cause higher risk of infection than antegrade locked intramedullary nailing. Incidences of nerve palsy and nonunion were comparable between the two methods. Future high-quality trials are required to overcome the limitation of mall population size currently presented.