[Indications and osteosynthesis procedures in humeral shaft fractures]

In the therapy of fractures of the humeral shaft, the individual patient's total condition should be taken into consideration when selecting the adequate method of treatment. Conservative treatment of humeral shaft fractures is still preferred, and Sarmiento's functional therapy has expanded the therapeutic possibilities. The decision for operative treatment is clarified by dividing the indications into the following categories: absolute, relative and recommended indications. In order to reduce complication rates and to ensure stability, we chose among three osteosynthetic procedures: 1. Bundle nailing. 2. Compression plate. 3. Fixateur externe (De Bastiani's mono-fixateur). In simple fractures of the shaft, bundle nailing is an effective and low-risk treatment. Compression plate is indicated in the presence of radial nerve palsy and in very distal shaft fractures. In open fractures and fractures with accompanying blood vessel damage, we favour stabilization with the De Bastiani's unilateral fixateur externe.