The humerus is anatomically and physiologically unique bone: firstly, it is a non-weight bearing bone; secondly, it has greatest range of motion; thirdly, while the person is standing, the axis of bone hangs vertically and is influenced by gravity, and conservative methods are usually used in treatment.
However. in the cases of closed reduction failure, open fracture, multiple fracture, and old age etc, operative methods may be employed.
This decision should be based on the type, location of fracture. the presence of concomittent injuries, the age, and the general condition of the patient.
When open reduction and internal fixation is carried out, the periosteum and soft tissue attachment is stripped off and operative time is longer
Flexible Ender nailing is a simple procedure which does not disrupt or strip off periosteum and soft tissue at the fracture site, and decreases the chance of infection and allows early exercise.
Authors carried out fixation in 28 patients and Ender nailing in 24 patients having humeral shaft fractures who were treated at the orthopedic department, Hae Dong hospital from March, 1990 to February, 1994.