Comparing The Effect Of Intramedullary Nail And Plate In Adult Humeral Shaft Fracture By Meta-analysis

Objective:To compare the therapeutic efficiency of the intramedullary nail and the plate in treatment of the adult humeral shaft fracture.Method:randomized trials about the comparison of the efect of intramedullary nail with plate in adult humeral shaft fracture were searched in Pubmed,OVID,CNKI and CBM between 1990～2007, and evaluated by methodological quality. The statistical software was RevMan 4.2.8 provided by the Cochrane Collaboration .Result:The 6 studies (involving 430 patients) were pooled according to Jadad score.The results showed that intramedullary nail fixation gave a lower relative risk of nonunion than plate [OR=0.44,95%CI(1.19, 6.04),P=0.04],but gave a higher relative risk of pain than plate[OR=1.89,95%CI(0.91, 3.91),P=0.09]. They were homogeneous (p > 0.1) in radial nerve injury,infection;Due to the differences in these studies,we used descriptive analysis to discuss shoulder function。Conclusion:Intramedullary nail fixation gave a lower relative risk of nonunion than plate,but higher relative risk of pain. There were no significant differences in other indicators.