Closed nailing of the humerus--from down under.

Closed intramedullary nailing of the humerus using a curved clover-leaf nail (Pohl nail) is a relatively minor operative procedure and is associated with few complications. The technique of the operation when performed from below (29 cases) and also from above (7 cases) is that as described initially by Kuntscher and his colleagues. This paper presents the technique and the experience from 1978 to 1985 with 36 cases (20 for metastatic bone deposits, four in multiple injury patients, three in patients with a severe head injury, four in patients with multiple fractures in the same limb and five in other patients particularly elderly women with osteoporotic bones). This review demonstrates the efficacy of closed intramedullary nailing of the humerus particularly when the nail is inserted into the humerus from below just proximal to the olecranon fossa.