The purpose of this study was to compare intramedullary nailing and plate fixation in the operative treatment of acute humeral shaft fractures.

The operation time, amount of blood transfusion, time to union, complications, and functional outcome were compared. At the Traumatology Clinic, Medical Faculty Skopje from 1995 to June 1999, 46 patients with acute humeral shaft fractures were operatively treated. The patients were divided into two groups: Group A – 24 patients treated with open reduction and internal fixation with dynamic compression plate, and Group B – 22 patients treated with closed reduction and intramedullary nailing (most of them with the Marchetti-Vicenci intramedullary nail). All of the fractures were classified according AO classification. The follow-up period was 6 to 12 months.

Intramedullary nailing of acute humeral shaft fractures offered a less invasive surgical procedure with less complications than open reduction and internal fixation. The results showed that the intramedullary nailing surgical procedure had a shorter operating time and less blood transfusion. There was no significant difference between the two groups regarding time to union. In Group A there was one patient with delayed union, two with deep infection and two with postoperative radial palsy. In Group B there were two patients with delayed union. Functional outcome for uncomplicated fractures was the same in both groups.