Le fratture diafisarie dell’omero: la fissazione esterna

Conservative treatment of diaphyseal humeral fractures is nowadays an effective option in terms of callogenesis and functional outcome: its selection is based on publications by Sarmiento and Rommers. However, the current trend is to provide a stable synthesis and early mobilization, leading to a quicker functional restore than that granted by conservative treatment. Therefore, endomedullary nailing (either anterograde or retrograde) and ORIF represent the gold standard. External fixation (EF) has absolute indications in case of open fractures, fractures with compromised soft tissue and multiple trauma, and represents an effective surgical option in case of closed fractures as well (both in adults and in children), thanks to its minimal invasiveness associated to good mechanical stability and functional restore. Patients’ quality of life is also very good during the first few weeks after surgery: the external fixator does not cause any trouble with shoulder and elbow mobility, allowing for a good restoration of muscular force. This method is even more indicated in elderly patients in overall poor medical conditions, where open invasive surgery would be contraindicated and conservative treatment would not be tolerated by the patients. Humeral external fixation can be considered a minimally invasive option that provides stable synthesis, with good fracture reduction and axial restoration: this leads to good results in terms of early mobilization, consolidation and low percentage of complications.