• OBJECTIVES
    • To compare the risk of major complications after either minimally invasive plate osteosynthesis (MIPO) or intramedullary nailing (IMN) of humeral shaft fractures.
  • DESIGN
    • Retrospective, case-match controlled study.
  • SETTING
    • A major metropolitan tertiary referral trauma center in Australia.
  • PATIENTS
    • Thirty patients with fractures of the humeral shaft.
  • INTERVENTION
    • Either MIPO or IMN were performed on 15 patients each with traumatic humeral shaft fractures.
  • PRIMARY OUTCOME MEASURE
    • The cumulative risk of 3 major complications associated with these procedures: nonunion, infection, and iatrogenic radial nerve injury.
  • RESULTS
    • An overall major complication rate of 53% was observed in the patients treated with IMN; one complication (7%) was identified in those managed with humeral MIPO, a nonunion. Complications after IMN included 4 patients (27%) with nonunion, 3 patients (20%) with iatrogenic radial nerve injuries, and 1 patient (7%) with a wound infection. Statistical analysis revealed a significant between-group difference (P = 0.01) in the cumulative rate of major complications. When each of these complications was considered independently, no statistically significant difference was demonstrated.
  • CONCLUSIONS
    • This study suggests that humeral MIPO results in a significantly lower pooled major complication rate than that of IMN, and it should therefore be considered an attractive alternative to IMN in those patients requiring surgical stabilization of a traumatic humeral shaft fracture.
  • LEVEL OF EVIDENCE
    • Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.