[New trends in the management of shaft fractures]

There is no major change in the indication of upper extremity fractures, although there is further refinement of plate design (LC-DCP), plate material (titanium), and operative technique ("biological osteosyntheses"). For lower extremity fractures, the external fixator has shown excellent results in the early phase of treatment, with some disadvantages the late phase. If a change to an intramedullary nail is planned, this should be performed in the early phase of treatment. The concept of the "pinless fixator" has shown great advantages for temporary stabilization, although further technical development is necessary. The claw interlocking nail allows easy distal locking without using X-rays. Unreamed nailing, with the advantage of less damage to the cortical blood supply and reduced pulmonary risk, will be of increasing importance, if the trend seen in current studies is confirmed.