Gosler Maurits W, Testroote Mark, Morrenhof J W, Janzing Heinrich M J
Department of Surgery and Orthopaedic Surgery, Viecuri Medical Centre of Northern Limburg, Venlo,
Cochrane Database Syst Rev. 2012 Jan 18;1:CD008832. doi: 10.1002/14651858.CD008832.pub2.
Fractures of the shaft of the humerus account for 1% to 3% of all fractures in adults. The management of these fractures, including surgical intervention, varies widely.
To assess and compare the effects of surgical versus non-surgical intervention for non-pathological fractures of the humeral shaft in adults.
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, trial registers, and bibliographies of trial reports. The full search was conducted in October 2011.
Considered for inclusion were all randomised and quasi-randomised (method of allocating participants to a treatment which is not strictly random; e.g. by date of birth, hospital record number or alternation) controlled trials that compared surgical with non-surgical intervention for humeral shaft fractures in adults.
Two authors independently selected and assessed potential eligible studies for inclusion.
We found six completed studies that appeared to meet our inclusion criteria. After scrutiny, we excluded all six studies: five were retrospective studies and one was a prospective study without randomisation. We identified three potentially eligible ongoing studies, two of which involve randomisation of treatment allocation and one, which we excluded, that does not.
AUTHORS' CONCLUSIONS: There is no evidence available from randomised controlled trials to ascertain whether surgical intervention of humeral shaft fractures gives a better or worse outcome than no surgery. Sufficiently powered good quality multi-centre randomised controlled trials comparing surgical versus non-surgical interventions for treating humeral shaft fractures in adults are needed. It is likely that the results from the two ongoing randomised trials on this topic will help inform practice in due course.
肱骨干骨折占成人所有骨折的1%至3%。这些骨折的治疗方法，包括手术干预，差异很大。
评估并比较成人肱骨干非病理性骨折的手术与非手术干预效果。
我们检索了Cochrane骨、关节和肌肉创伤小组专业注册库、Cochrane对照试验中央注册库、MEDLINE、EMBASE、试验注册库以及试验报告的参考文献。全面检索于2011年10月进行。
纳入的研究需为所有比较成人肱骨干骨折手术与非手术干预的随机和半随机（将参与者分配至治疗组的方法并非严格随机；例如按出生日期、医院记录编号或交替分配）对照试验。
两位作者独立选择并评估可能符合纳入标准的研究。
我们找到六项似乎符合纳入标准的已完成研究。经审查，我们排除了所有六项研究：五项为回顾性研究，一项为非随机前瞻性研究。我们确定了三项可能符合条件的正在进行的研究，其中两项涉及治疗分配随机化，一项未涉及随机化，我们将其排除。
随机对照试验尚无证据确定肱骨干骨折的手术干预与不手术相比，结果是更好还是更差。需要有足够样本量的高质量多中心随机对照试验来比较成人肱骨干骨折的手术与非手术干预。关于这一主题的两项正在进行的随机试验结果可能会在适当时候为临床实践提供参考。
