Humeral Shaft Fracture: Flexible Intramedullary Fixation
A 13-year-old female polytrauma patient presented with multiple injuries including a right closed transverse humeral shaft fracture. In this population, this fracture is commonly managed nonoperatively. However, for stability and mobilization indications, she was treated with flexible intramedullary nail fixation through a medial and lateral retrograde technique. Multiple options exist for flexible nail entry points, but key treatment strategy includes treating length-stable fractures, obtaining 80% intramedullary fill, and keeping a widespread of the nails at the fracture site. Care should be taken to avoid and protect the neurovascular bundles around the distal humeral entry points. She went on to robust healing and was allowed full weight-bearing at 6 weeks postoperatively.