[Can humerus shaft fractures be treated with osteosynthesis?].

The treatment of fractures of the humerus shaft is still controversial. The results of functional treatment (brace) are good, consolidation occurs in most cases within 8-10 weeks, slight malalignment can be accepted, and there is no risk of postoperative complications like osteitis, neurological iatrogenic disorders and technical errors. On the other hand a correct osteosynthesis allows painless functional postoperative treatment, the patient comfort is excellent and a selected group of patients might return to work faster. We present the results of plate fixation of humerus shaft fractures in 127 patients, operated from 1980 to 1988. 102 patients were clinically and radiologically controlled after 1 year: 85 patients (83.4%) presented an excellent or good result with complete functional recovery. 17 patients (16.6%) showed a limited range of motion in shoulder and/or elbow mostly due to other fractures of the same arm or to persistent neurological disorders (plexus or radial lesions). Postoperative complications included 2 postoperative radial palsies recovering completely within months, 5 failures of internal fixation due to technical errors, 2 pseudarthrosis and 4 postoperative infections, healed by reoperation and early removal of the implant with one exception (osteitis). We therefore conclude, that a correct plate fixation of humerus shaft fractures is an alternative to conservative treatment. The main advantage is better patient comfort and shorter disability for a selected group of patients.