Humerus Shaft Fracture in Adult Managed with Elastic Nails - A Case Report and Literature Review of Management Options

Sep 30, 2026

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A case report and literature review on managing adult humeral shaft fractures using elastic stable intramedullary nailing. The article describes a 68-year-old woman with an isolated closed left spiral humerus fracture treated with three 3 mm elastic nails placed within the medullary canal. Follow-up showed fracture healing without complications, preserving range of motion while avoiding stiffness or pain. The review compares conservative care with surgical options, highlighting the balance of stability and complication profiles.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Learning Point of the Article

Abstract

Introduction

Case Report

Conclusion

Keywords

Case Report Journal of Orthopaedic Case Reports 2025 December:15( 12) :Page 212-216 Humerus Shaft Fracture in Adult Managed with Elastic Nails: A Case Report and Literature Review of Management Options Ahmed MAlissa ¹, Adel Aldarwesh ¹, Adel FAlshihri¹, Alanoud A Sharee², GhadeerA Alsager¹, NoufA Altwaijri1 Learning Point of the Article: This case highlights that elastic stable intramedullary nailing can serve as a simple, minimally invasive, and effective alternative for selected humeral shaft fractures in adults. Abstract Introduction: Humerus fractures can be caused by significant force, minor incidents, or pre-existing bone conditions. They have been historically managed with either conservative or surgical management. Recently, a shift toward surgical management canbe seen duetothe need for quicker functional recovery. A recent method has emerged back to the surface, and its outcomes are being reported more and more, which is the method of closedreduction and fixation using bundling techniques. Case Report: We present a 68-year-old female who presented with an isolated closed left spiral humerus fracture atthejunction of the proximal ⅔ and distal ⅓ following a fall. She was managed with three elastic nails of size 3 mm filling the medullary canal. She was followed closely postoperatively and healedwithout issuesin range ofmotion, stiffness, or pain. Conclusion: This case study examines the management of a humeral fracture in a geriatric patient using three free-floating elastic intramedullary nails. The successful outcome of this approach suggests that this treatment option offers adequate stability for humeral shaft fracturesin older adults and canbe easily implemented in similar fracture patterns. Keywords: Humerusfractures, elasticnails, midshaft humerusfractures, closedreduction of humerusfractures, closedreduction. Introduction Humerus fractures can be caused by significant force, minor incidents, or pre-existing bone conditions [1]. Approximately 60% of humeral shaft fractures (HSFs) are diagnosed in individuals older than 50 years [2] . HSFs can be managed conservatively or surgically with open reduction and plate osteosynthesis, minimally invasive plate osteosynthesis, or with intramedullary nails (IMN) [3 ] . Historically, non-surgical treatment has been favored for humerus fractures due to the bone’s natural healing ability, the less strict requirements for perfect bone alignment, and the avoidance of surgical risks [4]. Despite the traditional preference for non-surgical treatment, there is a recent shift toward surgical intervention for humerus shaft fractures. This change is driven by the desire for early mobilization, quicker functional recovery, and the development of new surgical techniques and implants. Plate and nail fixation are the most common surgical techniques used to achieve high healing rates, accurate bone alignment, and optimal upper limb function [5]. Intramedullary nailing is an alternative surgical technique for fixing humerus shaft fractures. Compared to open reduction and internal fixation with a plate, intramedullary nailing has a lower risk of infection and post-operative radial nerve injury. However, it carries a higher risk of shoulder impingement, pain, and limited shoulder motion, and may require subsequent surgery to removethe implant [6]. Originally intended for treating long bone fractures in children, Elastic |
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Website:
[www.jocr.co.in](www.jocr.co.in)

DOI:
[https://doi.org/10.13107/jocr.2025.v15.i12.6512](https://doi.org/10.13107/jocr.2025.v15.i12.6512) |
1Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Saudi Arabia, 2Department of Orthopedic, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Address of Correspondence:
Dr. GhadeerA Alsager,
Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Saudi Arabia. [E-mail:](E-mail: ghadeer.alsagr@g

FAQs

What treatment approach does the article highlight for selected adult humeral shaft fractures?

Elastic stable intramedullary nailing is presented as a simple, minimally invasive, and effective alternative for selected adult humeral shaft fractures.

How was the reported patient’s fracture managed in the case report?

The 68-year-old woman was treated with three 3 mm elastic nails filling the medullary canal after closed reduction and internal fixation under general anesthesia.

What outcomes were observed after surgery in the case report?

The fracture healed without issues, with no problems in range of motion and no stiffness or pain reported.

Sep 30, 2026

Uploaded by acoobca