Review Question - QID 926

Humeral shaft fractures can be managed nonoperatively due to a high union rate with infrequent complications. Certain situations, however, favor operative osteosynthesis: failure of closed reduction, associated articular injury, vascular or brachial plexus injuries, associated ipsilateral forearm fractures, segmental fractures, and pathologic fractures. Open fractures should be irrigated and debrided if necessary with subsequent external or internal fixation. Polytrauma patients with multiple extremity or multi-system injuries may also be considered for operative stabilization. A relative indication also may be the transverse or short oblique fracture in an active patient since these fracture patterns are more prone to delayed union. An acute radial nerve palsy associated with a humeral shaft fracture is not an indication for surgery.