Humerus Shaft

Abstract

Intramedullary nailing of humerus shaft fractures has gained popularity in the last decades. Humerus intramedullary nailing has distinct biological and biomechanical advantages, but its use can be limited by the anatomical characteristics of the humerus, by fracture localization, fracture morphology and bone quality. Antegrade nailing can be done through small incisions with the patient supine. For retrograde nailing, the patient is placed in the prone position. A large enough entry portal and very careful nail insertion avoid fissures and fractures at the entry portal in retrograde nailing. Beside in acute fractures, humerus nailing can be done in hypertrophic non-union and in pathological fractures. When strictly adhering to the operative technique, a very high ratio of uneventful healing and excellent functional results can be expected. In comparative studies and meta-analysis, no clear difference in outcome between plate fixation and intramedullary nailing can be found.