Fractures of the Diaphysis of the Humerus. Our Therapeutic Vision

Introduction: Fractures of the humeral shaft are relatively common, accounting for approximately 1% to 5% of all fractures. The annual incidence ranges between 13 and 20 per 100,000 people and is higher with age. Several treatment options are possible: conservative treatment, open reduction and internal fixation with a plate, or closed reduction and intramedullary nailing. An external fixator is also an option. The purpose of this work is to show the results obtained in fractures of the humeral shaft, through minimally invasive fixation, with a fine intramedullary nail (Steimann) and a monopolar external fixator. Method: Prospective descriptive study with patients with humerus fracture in the period from January 2018 to August 2023, treated by osteosynthesis with a fine intramedullary nail (Steimann) and a monopolar external fixator, who underwent a six-month post-surgical follow-up. Results: 103 humeral shaft fractures were treated, classified according to AO/OTA as: 47 - A (21 - 12A1, 15 - 12A2 and 11 - 12A3); 31 – B (19 – 12B2 and 12 – 12B3) and the remaining 25 were type C fractures (14 – 12C2 and 11 – 12C3). In some cases, basically in groups 12B and 12C, it was required to increase interfragmentary compression after 6 - 8 weeks due to little bone callus visible on radiographs, consolidation was achieved in 98% of the patients between 12 and 16 weeks, without presence of neurological injury (radial nerve) and functional recovery of the scapulohumeral joint was complete in all cases. Conclusion: Minimum invasive osteosynthesis of humerus shaft fractures with closed fine intramedullary nail and monopolar external fixator produces good results related to bone consolidation and scapulo-humeral functional recovery, in a relatively short time.