Prospective randomised controlled trials (RCTs) and quasi-RCTs that compared plate fixation with intramedullary nail fixation in participants with fractures of the humeral diaphysis were eligible for inclusion. The primary outcome of interest was total complications due to surgery:(non-union, infection, implant failure, nerve damage, malunion, reduced range of movement (ROM) of the shoulder, reduced ROM of the elbow, intraoperative comminution (breaking of the bone), wound haematoma, delayed union, hardware requiring removal, impingement, shoulder pain and elbow pain. Secondary outcomes were specific complications that included infection, non-union, nerve palsy and reoperation rate.
Included studies assessed open reduction internal fixation with plates or rigid intramedullary nails. Where reported, the mean age of patients who received plates ranged from 34 to 49 years and the mean age of patients who received nails ranged from 33 to 40 years.
Two reviewers independently screened studies for inclusion.