Hackethal stacked nailing of humeral shaft fractures. Experience with 30 patients.

The Hackethal technique of using stacked medullary pins for fixation of humeral shaft fractures is usually associated with relatively little blood loss; in addition, exposure of the fracture site and possible associated muscular trauma are avoided, and the risk of contusion of the radial nerve that may occur in fixation by plate and screws is eliminated. The technique has the additional advantage of accomplishing stable fixation of the fracture, thus allowing early motion of both the shoulder and the elbow. The rate of union in 25 patients with adequate follow-up evaluation was 92%, with a reoperation rate of 14%. This high rate may be decreased further by increased experience. The method proves effective in the stabilization of pathologic fractures.