Humeral shaft fractures

Abstract

Management of humeral shaft fractures has historically been largely conservative. A significant body of literature, dating back to the 1970s, has shown that functional bracing may achieve greater than 90 % union rates and acceptable functional outcomes. More recently, however, with the advent of new surgical techniques and implant options, less tolerance for acceptable deformity and functional deficits, and less patience with conservative management, many treating orthopaedic surgeons are increasingly likely to consider surgical intervention. This article reviews the current recommendations for treatment of humeral shaft fractures, including both nonoperative and operative intervention. It also discusses the current thinking and operative trends in humeral shaft fracture fixation.

Fig. 1

Three examples of different humeral shaft fracture stabilization options determined by the personality and location of the fracture. Posterolateral precontoured periarticular plate with lag screw fixation for a distal humeral shaft fracture through a posterior approach. Anterior humeral compression plating through an anterolateral approach for a simple, diaphyseal, short oblique fracture with minimal comminution. Intramedullary nailing for a comminuted proximal third humeral shaft fracture