Closed intramedullary fixation of humeral shaft fractures.

During a seven-year prospective study, 158 humeral shaft fractures in 157 patients were treated with closed intramedullary nailing. Only humeral fractures not responsive to closed reduction and immobilization and those in noncomplaint patients were eligible. No immobilization was used postoperatively. Seven patients were lost to follow-up. A total of 148 fractures healed; there were three nonunions. The average time to clinical union was 7.2 weeks. There were no infections or malunions. Eight of 11 preoperative and three postoperative radial nerve palsies were lesions in continuity and healed spontaneously. The remaining three had been severed by missiles and needed further attention. Nail withdrawal occurred in eight patients; five of these needed nail revision. Final range of motion for the elbow averaged 132 degrees and shoulder abduction-external rotation averaged 168 degrees.