INTRAMEDULLARY NAILING OF THE HUMERUS AS AN ALTERNATIVE TO CONSERVATIVE THERAPY AND PLATE OSTEOSYNTHESIS

For humeral shaft fractures conservative treatment, plate osteosynthes is and IM nailing are possible options according to the localization, type of fracture or additional soft tissue problems. While the majorit y of humeral shaft fractures is still treated conservatively, today an increasing number of fractures is felt to be suitable for ORIF. Pseud arthroses, pathological fractures, multiple fractures or polytrauma, v ery severe open fractures, soft tissue interposition or concomitant ne rve or vascular injuries are all indications for operative treatment. We think that plate osteosynthesis is still the standard. IM interlock ing nailing has been shown to be advantageous for early rehabilitation and low radial nerve damage rates. In IM nailing it is still necessar y to improve the implants and implantation techniques. A retrograde ex tra-articular nailing technique with elastic implants is preferable. T he preliminary results for a newly developed elastic nail (''Monachia Nail'') in 18 patients are very promising with respect to the implanta tion technique, fracture healing and functional rehabilitation.