Abstract
Operative treatment of humeral shaft fractures has gained increasing significance compared to conservative treatment. On the other hand, there is no acceptance of operative techniques as plate osteosynthesis, external fixation and elastic nailing as a golden standard. Conservative treatment shows good results in adequate cases still today. The new unreamed humeral nail (UHN) has been developed on the base of experience with the problems of other nail systems and can be inserted retrograde. The results of a prospective study with 102 humeral shaft fractures being treated with retrograde nailing will be presented. The most significant complications of nail insertion are fissures at the entry portal in 3.9% and secondary pareses of the radial nerve in 3.9%. 75 patients could be followed until fracture healing. Five fractures (6.7%) needed a secondary intervention for healing. Almost 90% of the patients showed an excellent or good shoulder- and elbow-function postoperatively. Combined with high fracture fixation capacity and good fragment adaptation retrograde humeral nailing with the UHN is a reliable operative treatment for fresh and pathologic humeral shaft fractures and non-unions.
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