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Internal Fixation of Diaphyseal Humeral Fractures: Plate or Intramedullary Nail?

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Simple and Complex Fractures of the Humerus

Abstract

Operative treatment of humeral shaft fractures includes intramedullary nailing (IMN) and plating (PLT); each one has advantages and disadvantages. IMN offers a more biologic approach as well as cosmetic advantages. PLT allows fragment manipulation and exploration of the radial nerve. The entrance hole produced at the shoulder or elbow by IMN increases the incidence of stiffness and pain. A fracture with a short metaphyseal segment demands PLT. Segmental fractures and pathological fractures are best treated with IMN. Few randomized studies comparing results of IMN versus PLT have been published. Most of these are small series with several bias errors. The results of meta-analysis of comparative studies are of limited value and suggest a higher reoperation rate and a higher incidence of iatrogenic radial nerve palsy after IMN. No differences seem to occur as far as time to union, nonunion, and deep infection. In conclusion, there is a weak evidence that PLT may reduce complications and reoperation rates in comparison to IMN. Further studies are needed to clarify the superiority of one technique over the other.

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Authors and Affiliations

  1. Department of Traumatology and General Orthopaedics, AOU Careggi, Careggi Hospital, Largo Palagi 1, Florence, 50139, Italy

    Michele James Ceglia MD, Stefano Bianco MD, Antonio Ciardullo MD & Roberto Buzzi MD

Authors
  1. Michele James Ceglia MD
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  2. Stefano Bianco MD
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  3. Antonio Ciardullo MD
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  4. Roberto Buzzi MD
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Corresponding author

Correspondence to Michele James Ceglia MD .

Editor information

Editors and Affiliations

  1. Department of Orthopaedics and Traumatology, CTO Hospital Turin, Turin, Italy

    Filippo Castoldi

  2. Department of Orthopaedics and Traumatology, Mauriziano-Umberto I Hospital, Turin, Italy

    Davide Blonna

  3. Department of Orthopaedics and Traumatology, Mauriziano-Umberto I Hospital, Turin, Italy

    Marco Assom

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Ceglia, M.J., Bianco, S., Ciardullo, A., Buzzi, R. (2015). Internal Fixation of Diaphyseal Humeral Fractures: Plate or Intramedullary Nail?. In: Castoldi, F., Blonna, D., Assom, M. (eds) Simple and Complex Fractures of the Humerus. Springer, Milano. https://doi.org/10.1007/978-88-470-5307-6_20

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  • DOI: https://doi.org/10.1007/978-88-470-5307-6_20

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5306-9

  • Online ISBN: 978-88-470-5307-6

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