[Recent fractures of the humeral diaphysis in adults. Comparison of orthopedic and surgical treatment. Apropos of 252 cases].

Two hundred and fifty two cases of fracture of the humeral shaft have been treated by the authors, half conservatively by mobilisation against the chest wall and half surgically. The main surgical procedures were plating, nailing without reaming, fascicular intramedullary pinning, or external fixation. Conservative treatment gave satisfactory results without iatrogenic complications. However, significant limitation of movement was seen in 61 cases and was severe in 14. Eight non-unions occurred. The best surgical fixation was either by intramedullary nailing or fascicular intramedullary pinning in fractures of the upper third or the middle third of the humeral shaft. These techniques resulted in very few post operative radial palsies. Plating is indicated in unstable fractures of the lower third of the humerus. Conservative treatment or blind intramedullary nailing or pinning is indicated in cases of initial radial palsy, the nerve being explored only after three to six months in the absence of recovery.