Clinical effect of operative vs nonoperative treatment on humeral shaft fractures: Systematic review and meta-analysis of clinical trials

Table 1 Characteristics of the 17 studies included in the meta-analysis

Ref.	Year	Study design	Simple size	Mean/median age (year)		Female/male, n		Type of fracture, (AO/OTA: A/B/C), n		Treatment		Mean FU (months)
			OP/non-OP	OP	Non-OP	OP	Non-OP	OP	Non-OP	OP	Non-OP
Rämö et al[25]	2020	RCT	38/44	49.6	48.4	18/12	10/24	34/4/0	36/7/1	ORPO	FB	12
Kumar et al[26]	2017	RCT	20/20	37.6	32.7	5/15	6/14	20/0/0	19/1/0	ORPO	FB	6
Hosseini et al[24]	2019	RCT	30/30	NA	NA	7/23	4/26	18/4/8	21/5/4	ORPO	FB	12
Matsunaga et al[23]	2017	RCT	58/52	37.3	40.3	23/35	14/38	38/15/3	28/17/6	MIPO	FB	12
Wallny et al[32]	1997	Cohort	45/44	56	59	19/26	20/24	NA	NA	Nail	FB	27
Jawa et al[15]	2006	Cohort	19/21	50	41	8/11	12/9	NA	NA	ORPO	FB	21
Oliver et al[27]	2021	Cohort	139/523	44.7	58.5	60/79	299/224	82/53/4	169/283/72	ORPO, nail	FB	5
Westrick et al[19]	2017	Cohort	227/69	31	42	144/52	35/34	NA	NA	ORPO, nail	FB	12
Mahabier et al[16]	2013	Cohort	95/91	61.1	60.6	51/44	55/36	52/35/8	42/42/7	ORPO	FB	NA
Harkin and Large[18]	2017	Cohort	30/96	NA	NA	21/9	64/32	NA	NA	ORPO, nail	FB	NA
Dielwart et al[28]	2017	Cohort	40/31	37.5	39.3	22/18	8/23	23/8/9	16/7/8	ORPO, nail	FB	10.6
Osman et al[31]	1998	Cohort	72/32	48	48	NA	NA	NA	NA	ORPO, nail	Splint	NA
Ekholm et al[30]	2008	Cohort	7/20	47.6	52.6	3/4	15/3	7/0/0	20/0/0	ORPO, nail	FB	74.4
Denard et al[29]	2010	Cohort	150/63	34.9	36.4	68/82	29/34	NA	NA	ORPO	FB	NA
Den Hartog et al[17]	2022	Cohort	245/145	53	62	94/51	133/112	171/74/0	92/53/0	ORPO, nail	FB	12
van Middendorp et al[11]	2011	Cohort	33/14	53	51	14/19	9/5	6/17/10	6/5/3	Nail	FB	12
Cannada et al[33]	2021	Cohort	45/57	41	41.5	14/31	25/32	26/17/2	30/20/7	ORPO	FB	6

Because of the follow-up lost, the number of patients may less than that of the primary simple size. NA: Not available; RCT: Randomized clinical trials; ORPO: Open reduction and plate osteosynthesis; FU: Follow up; FB: Functional bracing; AO/OTA: AO Foundation and Orthopaedic Trauma Association; MIPO: Minimally invasive percutaneous plate osteosynthesis; OP: Operation.

Table 2 Quality assessment of the 13 cohort studies using the Newcastle-Ottawa Scale

Ref.	Selection	Comparability	Outcome	Total	Study quality
Wallny et al[32]	++++	+	++	7 +	High
Jawa et al[15]	++++		++	5 +	High
Oliver et al[27]	++++		++	5 +	High
Westrick et al[19]	++++		++	5 +	High
Mahabier et al[16]	++++	++	+++	9 +	High
Harkin and Large[18]	+++	+	+	5 +	High
Dielwart et al[28]	+++	+	++	6 +	High
Osman et al[31]	+++		+	4 +	Low
Ekholm et al[30]	+++	+	+++	7 +	High
Denard et al[29]	+++	+	+	5 +	High
Den Hartog et al[17]	++++	+	+++	8 +	High
van Middendorp et al[11]	++++	+	++	7 +	High
Cannada et al[33]	++	+	+	4 +	Low

Scale: Zero to 9 +; 5 or more + indicates a higher quality study.