{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T10:02:12Z","timestamp":1768903332093,"version":"3.49.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007833","name":"Hamad Medical Corporation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007833","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Humeral shaft fractures account for 1\u20133% of all bone fractures. Conservative treatment often leads to complications such as non-union and shoulder stiffness. Surgical fixation with a dynamic compression plate (DCP) has been the gold standard treatment. Intramedullary nailing (IMN) has recently gained popularity due to its minimally invasive approach and reduced risk of radial nerve injury. This study aims to compare the outcomes of IMN and plate fixation for humeral shaft fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included patients with humeral shaft fractures treated with either IMN or DCP fixation at Hamad General Hospital between April 2015 and October 2018. Patient demographics, fracture characteristics, surgical outcomes, and complications were collected. Descriptive statistics were used to summarize patient information, and univariate analysis was conducted to compare both groups. A Cox proportional hazards model, adjusted for age, gender, and polytrauma status was applied to compare time to union between IMN and DCP groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty five patients (25 IMN, 40 plate fixation) were included. Non-union rates were higher in the DCP group than in the IMN group (13% vs. 4%). Reoperation rates were also higher in the DCP group (20% vs. 4%). Postoperative neuropathy rates were 4% for IMN and 10% for DCP, with neuropathy resolution significantly higher in the IMN group (92% vs. 68%). Shoulder range of motion (ROM) and pain favored the DCP group, with 98% unaffected ROM in the plate group compared to 76% in the IMN group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), and a lower incidence of shoulder pain (28% vs. 98%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Time to union was comparable between both groups, with an adjusted hazard ratio of 1.08 (95% CI 0.62\u20131.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.776).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IMN and plate fixation effectively achieved fracture union; however, plate fixation was associated with better shoulder function, reduced pain, and higher reoperation rates. IMN was linked to a lower risk of nerve injury but compromised shoulder ROM and resulted in more postoperative pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00590-025-04181-z","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T21:16:04Z","timestamp":1738876564000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study"],"prefix":"10.1007","volume":"35","author":[{"given":"Jawad","family":"Derbas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isam","family":"Moghamis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama","family":"Alzobi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amgad","family":"Elshoeibi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Murshid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghalib","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"4181_CR1","doi-asserted-by":"publisher","first-page":"290","DOI":"10.2106\/00004623-200402000-00011","volume":"86","author":"MR Brinker","year":"2004","unstructured":"Brinker MR, O\u2019Connor DP (2004) The incidence of fractures and dislocations referred for orthopaedic services in a capitated population. J Bone Joint Surg Am 86:290\u2013297","journal-title":"J Bone Joint Surg Am"},{"key":"4181_CR2","first-page":"1481","volume-title":"Skeletal trauma","author":"EH Schemitsch","year":"2001","unstructured":"Schemitsch EH, Bhandari MF (2001) Fractures of the diaphyseal humerus. In: Browner BD, Jupiter JB, Levine AM, Trafton PG (eds) Skeletal trauma, 3rd edn. WB Saunders, Toronto, pp 1481\u20131511","edition":"3"},{"key":"4181_CR3","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1067\/mse.2002.121634","volume":"11","author":"PP Koch","year":"2002","unstructured":"Koch PP, Gross DFL, Gerber C (2002) The results of functional (Sarmiento) bracing of humeral shaft fractures. J Shoulder Elbow Surg 11:143\u2013150. https:\/\/doi.org\/10.1067\/mse.2002.121634","journal-title":"J Shoulder Elbow Surg"},{"key":"4181_CR4","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1093\/milmed\/88.5.542","volume":"88","author":"AM Wright","year":"1941","unstructured":"Wright AM, Koenig GA, Shafiroff B (1941) The extension hanging cast for fractures of the humerus. Mil Med 88:542\u2013546. https:\/\/doi.org\/10.1093\/milmed\/88.5.542","journal-title":"Mil Med"},{"key":"4181_CR5","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1186\/s13018-024-04794-w","volume":"19","author":"A Nshimiyimana","year":"2024","unstructured":"Nshimiyimana A, de la Ingabire JCA, Byiringiro JC et al (2024) The outcome of nonoperative treatment for adult humeral shaft fractures using a U-shaped slab in resource-limited settings: a prospective cohort study. J Orthop Surg Res 19:316. https:\/\/doi.org\/10.1186\/s13018-024-04794-w","journal-title":"J Orthop Surg Res"},{"key":"4181_CR6","first-page":"157","volume":"89","author":"VK Sharma","year":"1991","unstructured":"Sharma VK, Jain AK, Gupta RK et al (1991) Non-operative treatment of fractures of the humeral shaft: a comparative study. J Indian Med Assoc 89:157\u2013160","journal-title":"J Indian Med Assoc"},{"key":"4181_CR7","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.jse.2014.05.009","volume":"24","author":"E Ali","year":"2015","unstructured":"Ali E, Griffiths D, Obi N et al (2015) Nonoperative treatment of humeral shaft fractures revisited. J Shoulder Elbow Surg 24:210\u2013214. https:\/\/doi.org\/10.1016\/j.jse.2014.05.009","journal-title":"J Shoulder Elbow Surg"},{"key":"4181_CR8","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1177\/1758573220937402","volume":"13","author":"C Kocialkowski","year":"2021","unstructured":"Kocialkowski C, Sheridan B (2021) Humeral shaft fractures: how effective really is functional bracing? Shoulder Elbow 13:620\u2013626. https:\/\/doi.org\/10.1177\/1758573220937402","journal-title":"Shoulder Elbow"},{"key":"4181_CR9","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1097\/01.bot.0000246466.01287.04","volume":"20","author":"R Ekholm","year":"2006","unstructured":"Ekholm R, Tidermark J, T\u00f6rnkvist H et al (2006) Outcome after closed functional treatment of humeral shaft fractures. J Orthop Trauma 20:591\u2013596. https:\/\/doi.org\/10.1097\/01.bot.0000246466.01287.04","journal-title":"J Orthop Trauma"},{"key":"4181_CR10","first-page":"346","volume":"86","author":"H Paris","year":"2000","unstructured":"Paris H, Tropiano P, Clouet D\u2019orval B et al (2000) Fractures of the shaft of the humerus: systematic plate fixation: anatomic and functional results in 156 cases and a review of the literature. Rev Chir Orthop Reparatrice Appar Mot 86:346\u2013359","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"key":"4181_CR11","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s00068-017-0775-9","volume":"44","author":"TR Schwab","year":"2018","unstructured":"Schwab TR, Stillhard PF, Schibli S et al (2018) Radial nerve palsy in humeral shaft fractures with internal fixation: analysis of management and outcome. Eur J Trauma Emerg Surg 44:235\u2013243. https:\/\/doi.org\/10.1007\/s00068-017-0775-9","journal-title":"Eur J Trauma Emerg Surg"},{"key":"4181_CR12","doi-asserted-by":"publisher","first-page":"317","DOI":"10.3109\/17453674.2012.695677","volume":"83","author":"DJ Heineman","year":"2012","unstructured":"Heineman DJ, Bhandari M, Poolman RW (2012) Plate fixation or intramedullary fixation of humeral shaft fractures: an update. Acta Orthop 83:317\u2013318. https:\/\/doi.org\/10.3109\/17453674.2012.695677","journal-title":"Acta Orthop"},{"key":"4181_CR13","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1007\/s00402-004-0727-9","volume":"124","author":"T Flinkkil\u00e4","year":"2004","unstructured":"Flinkkil\u00e4 T, Hyv\u00f6nen P, Siira P, H\u00e4m\u00e4l\u00e4inen M (2004) Recovery of shoulder joint function after humeral shaft fracture: a comparative study between antegrade intramedullary nailing and plate fixation. Arch Orthop Trauma Surg 124:537\u2013541. https:\/\/doi.org\/10.1007\/s00402-004-0727-9","journal-title":"Arch Orthop Trauma Surg"},{"key":"4181_CR14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0173634","volume":"12","author":"J-G Zhao","year":"2017","unstructured":"Zhao J-G, Wang J, Meng X-H et al (2017) Surgical interventions to treat humerus shaft fractures: a network meta-analysis of randomized controlled trials. PLoS ONE 12:e0173634. https:\/\/doi.org\/10.1371\/journal.pone.0173634","journal-title":"PLoS ONE"},{"key":"4181_CR15","doi-asserted-by":"publisher","first-page":"215","DOI":"10.5435\/00124635-199707000-00005","volume":"5","author":"PR Gregory","year":"1997","unstructured":"Gregory PR, Sanders RW (1997) Compression plating versus intramedullary fixation of humeral shaft fractures. J Am Acad Orthop Surg 5:215\u2013223. https:\/\/doi.org\/10.5435\/00124635-199707000-00005","journal-title":"J Am Acad Orthop Surg"},{"key":"4181_CR16","doi-asserted-by":"publisher","first-page":"S69","DOI":"10.1016\/j.injury.2017.04.020","volume":"48","author":"BP Cunningham","year":"2017","unstructured":"Cunningham BP, Brazina S, Morshed S, Miclau T (2017) Fracture healing: a review of clinical, imaging and laboratory diagnostic options. Injury 48:S69\u2013S75. https:\/\/doi.org\/10.1016\/j.injury.2017.04.020","journal-title":"Injury"},{"key":"4181_CR17","doi-asserted-by":"publisher","unstructured":"(2013) World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA 310:2191. https:\/\/doi.org\/10.1001\/jama.2013.281053","DOI":"10.1001\/jama.2013.281053"},{"key":"4181_CR18","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1302\/0301-620x.82b3.9675","volume":"82","author":"RG McCormack","year":"2000","unstructured":"McCormack RG, Brien D, Buckley RE et al (2000) Fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail: a prospective, randomised trial. J Bone Joint Surg Br 82:336\u2013339. https:\/\/doi.org\/10.1302\/0301-620x.82b3.9675","journal-title":"J Bone Joint Surg Br"},{"key":"4181_CR19","doi-asserted-by":"publisher","DOI":"10.5812\/traumamon.26271v2","author":"AA Esmailiejah","year":"2015","unstructured":"Esmailiejah AA, Abbasian MR, Safdari F, Ashoori K (2015) Treatment of humeral shaft fractures: minimally invasive plate osteosynthesis versus open reduction and internal fixation. Trauma Mon. https:\/\/doi.org\/10.5812\/traumamon.26271v2","journal-title":"Trauma Mon"},{"key":"4181_CR20","doi-asserted-by":"publisher","first-page":"661","DOI":"10.22038\/ABJS.2021.59413.2947","volume":"10","author":"KM Amer","year":"2022","unstructured":"Amer KM, Kurland AM, Smith B et al (2022) Intramedullary nailing versus plate fixation for humeral shaft fractures: a systematic review and meta-analysis. Arch Bone Jt Surg 10:661\u2013667. https:\/\/doi.org\/10.22038\/ABJS.2021.59413.2947","journal-title":"Arch Bone Jt Surg"},{"key":"4181_CR21","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1097\/00005131-200003000-00002","volume":"14","author":"JR Chapman","year":"2000","unstructured":"Chapman JR, Henley MB, Agel J, Benca PJ (2000) Randomized prospective study of humeral shaft fracture fixation: intramedullary nails versus plates. J Orthop Trauma 14:162\u2013166. https:\/\/doi.org\/10.1097\/00005131-200003000-00002","journal-title":"J Orthop Trauma"}],"container-title":["European Journal of Orthopaedic Surgery &amp; Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-025-04181-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00590-025-04181-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-025-04181-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T13:43:54Z","timestamp":1767015834000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00590-025-04181-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,7]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4181"],"URL":"https:\/\/doi.org\/10.1007\/s00590-025-04181-z","relation":{},"ISSN":["1432-1068"],"issn-type":[{"value":"1432-1068","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,7]]},"assertion":[{"value":"11 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"63"}}