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Compression Plating Versus Intramedullary Fixation of Humeral Shaft Fractures

Florida Orthopaedic Institute, Tampa.

Most humeral shaft fractures do not require surgery. When operative stabilization is indicated, the surgeon can choose between compression plating and intramedullary fixation. The results after compression plating have been shown to be predictable with respect to healing, alignment, and range of motion of the shoulder and elbow joints. Although complications are unusual with plate fixation, the procedure can require extensive dissection and operative time. Intramedullary fixation offers an alternative to plate fixation, with the principal advantage being a limited surgical dissection. This benefit must be balanced against the reportedly high rate of postoperative shoulder problems seen with antegrade nail placement. Unfortunately, few direct comparative studies have been done to evaluate the various techniques. The authors attempt to clarify and resolve these issues.