Abstract:

BACKGROUND: The humeral shaft fractures are commonly treated with small splints, plaster, functional scaffold external fixation and internal fixation of plates and screws, intramedullary nails and so on. But each treatment approach to the biological mechanisms of bone healing is different. Therefore, each has its unique clinical indications.
OBJECTIVE: To compare efficacy between small splint external fixation and internal fixation of plates and screws, intramedullary nails and kirschner wires for the treatment of closed humeral shaft fracture by using Meta-analysis.
METHODS: Computer-based online search of Medline, CBM, CNKI, EMCC, and VIP  databases was performed to collect related articles with the test group treated with small splint external fixation, while control group with internal fixation of plates and screws, intramedullary nails and kirschner wires. Differences in efficacy and evaluation indicators were odds ratio (OR), weighted mean difference and 95% confidence interval (CI).
RESULTS: A total of 7 clinically controlled studies were included in the final analysis containing 1 390 patients. Among the patients, 1 007 cases were treated with small splint external fixation and 383 with internal fixation. All the 7 controls were performed with Meta-analysis. ①Fracture reduction excellent rate, fracture union tie, nonunion rate of experimental group were less than control [OR=0.20, 95%CI (0.03,1.20), P=0.08; OR=-33.69, 95%CI (-44.67, -22.72), P < 0.000 01; OR=0.31, 95%CI (0.16,0.60), P=0.000 5]. ②Fractures normal union rate and functional of shoulder and elbow joints excellent rate of experimental group were greater than control [OR=3.04, 95%CI(1.95,4.75), P < 0.000 01, OR=8.02,95%CI (2.68,24.04), P=0.000 2]. Meta-analysis results demonstrated that small splint external fixation is safe and effective. Additionally, clinical efficacy of small splint external fixation was superior to that of internal fixation of plates and screws, intramedullary nails and kirschner wires.