Operative Orthopädie und Traumatologie
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Restoring humeral shaft alignment using direct or indirect reduction techniques with subsequent intramedullary stabilisation with an antegrade or retrograde inserted humeral nail. Achieving osseous union and restoration of painfree upper arm function. ⋯ Very good healing results with excellent clinical and radiological healing are achieved in more than 90% of cases after both antegrade and retrograde nailing. Intraoperative problems that have been reported in up to 40% of cases occurred mainly with former generation nails or were attributable to technical errors. Correspondingly, with the closed reduction technique postoperative infections are rare (< 3%). Undesirable distraction at the fracture site is successfully corrected by intraoperative interfragmentary compression. Success and complication rates after intramedullary nailing and plate fixation are not significantly different. Functional shoulder-related problems may occur after antegrade nailing, whereas elbow problems may occur after retrograde nailing.