{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T06:58:27Z","timestamp":1767164307256,"version":"build-2238731810"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To assess whether patients treated with a Minimally Invasive Rotator-Interval Technique (MIR-IT) versus the traditional technique of splitting the rotator cuff (RTCS) for intramedullary nailing of humeral shaft fractures resulted in comparable postoperative clinical and patient-reported outcomes (PROM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Level 1 trauma center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Selection Criteria:<\/jats:title>\n                    <jats:p>Patients &gt;18 years old with humeral shaft fractures (AO\/OTA 12A-C) treated with IMN between 2015 and 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measures and Comparisons:<\/jats:title>\n                    <jats:p>The primary outcome was differences in PROMs (American Shoulder and Elbow Surgeons Score, Quick DASH, and Oxford Shoulder Score) between the MIR-IT and RTCS techniques. Secondary outcome measures included differences in rates of nonunion, superficial and deep surgical infections, wound dehiscence, and iatrogenic nerve palsy between the 2 techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Seventy-one patients underwent humeral IMN (MIR-IT-39; RTCS-32). Fifty-five patients (MIR-IT-30; RTCS-25) had radiographic and clinical follow-up to union. Mean follow-up was 7.5 months (range: 3.1\u201316.8 months). Patients did not vary significantly regarding age (MIR-IT: 54.4 \u00b1 22.4; RTCS: 55.1 \u00b1 18.5 years,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.896) and sex (males- MIR-IT: 46.7%, RTCS: 44%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.843). There were no significant differences in nonunion (7.4% vs. 4.0%\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 1.0), superficial infection (3.6% vs. 4%\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 1.0), or iatrogenic nerve palsy (3.6% vs. 4.0%\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 1.0) between the MIR-IT and RTCS groups. There were no deep infections or wound dehiscences in either group.\n                    <\/jats:p>\n                    <jats:p>\n                      Forty-two patients had PROMs (MIR-IT -21; RTCS -21). Average time to PROMs collection was 35.7 months (MIR-IT: 34.2 months, RTCS: 37.1 months,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.682). There were significantly better American Shoulder and Elbow Surgeons Scores (82.7 vs. 71.6\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.015), Quick DASH scores (9.7 vs. 21.0\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.011), and Oxford Shoulder Scores (39.3 vs. 33.9\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.042) among patients treated with the MIR-IT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Humeral IMN using the MIR-IT resulted in better shoulder PROMs than the RTCS technique, with similarly low surgical complication rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bot.0000000000002993","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T09:00:40Z","timestamp":1744362040000},"page":"345-351","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Humeral Intramedullary Nailing Using the Minimally Invasive Rotator-Interval Technique Improves Shoulder PROMs"],"prefix":"10.1097","volume":"39","author":[{"given":"Lazaro","family":"Mesa","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, University of South Florida, Tampa, FL, USA; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian M.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of South Florida, Tampa, FL, USA; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reed","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of South Florida, Tampa, FL, USA; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchel","family":"John","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of South Florida, Tampa, FL, USA; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Abdelghany","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of South Florida, Tampa, FL, USA; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maykel","family":"Dolorit","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of South Florida, Tampa, FL, USA; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5871-4741","authenticated-orcid":false,"given":"Mir Ibrahim","family":"Sajid","sequence":"additional","affiliation":[{"name":"Orthopaedic Trauma Service, Florida Orthopaedic Institute, Tampa, FL, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Watson","sequence":"additional","affiliation":[{"name":"Orthopaedic Trauma Service, Florida Orthopaedic Institute, Tampa, FL, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0260-3468","authenticated-orcid":false,"given":"Hassan R.","family":"Mir","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of South Florida, Tampa, FL, USA; and"},{"name":"Orthopaedic Trauma Service, Florida Orthopaedic Institute, Tampa, FL, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20250613","doi-asserted-by":"crossref","first-page":"2567","DOI":"10.1016\/j.jse.2023.07.015","article-title":"Intramedullary nailing vs. open reduction-internal fixation for humeral shaft fractures: a meta-analysis of randomized controlled trials","volume":"32","author":"Hurley","year":"2023","journal-title":"J Shoulder Elbow Surg."},{"key":"R2-20250613","doi-asserted-by":"crossref","first-page":"596","DOI":"10.2106\/00004623-197759050-00004","article-title":"Functional bracing of fractures of the shaft of the humerus","volume":"59","author":"Sarmiento","year":"1977","journal-title":"J Bone Joint Surg Am."},{"key":"R3-20250613","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.jseint.2020.08.013","article-title":"Treatment of nonunions of the humeral shaft with nonvascularized fibular strut allograft: postoperative outcomes and review of a surgical technique","volume":"4","author":"Fink Barnes","year":"2020","journal-title":"JSES Int."},{"key":"R4-20250613","doi-asserted-by":"crossref","first-page":"5035","DOI":"10.1007\/s00402-023-04836-8","article-title":"Humeral shaft fracture: systematic review of non-operative and operative treatment","volume":"143","author":"Van Bergen","year":"2023","journal-title":"Arch Orthop Trauma Surg."},{"key":"R5-20250613","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/1758573218825477","article-title":"Operative versus non-operative treatment of humeral shaft fractures: a systematic review","volume":"12","author":"Sargeant","year":"2020","journal-title":"Shoulder Elb"},{"key":"R6-20250613","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1302\/0301-620X.82B3.0820336","article-title":"Fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail. 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