[Humeral shaft fractures]

R Biber, H J Bail, M Geßlein
Der Unfallchirurg 2018, 121 (9): 747-758
There is still no gold standard for the treatment of humeral shaft fractures. This might be attributed to the fact that several commonly used treatment methods have shown good clinical results. A bimodal age distribution of humeral shaft fractures with frequency peaks between 20 and 30 years old and above 60 years old is reported. Decision making for conservative or operative treatment depends not only on the injury pattern but is also dependent on individual patient needs. Currently available operative techniques include antegrade and retrograde interlocking medullary nailing as well as the use of longer proximal humeral nails. Plate osteosynthesis can be performed as open reduction and internal fixation (ORIF) or as minimally invasive plate osteosynthesis (MIPO). There is currently insufficient evidence for a clear superiority of either of the methods. Radial nerve palsy is the most typical complication of humeral shaft fractures but an improved outcome is not achieved by an emergency revision of the nerve.

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