We report results of intramedullary nailing in humeral shaft fracture and upon the many factors which contributed to shoulder pain & motion limitations.

We reviewed the clinical results in twenty seven patients with a minimal 1 year follow up. There were 18 fresh fractures and 8 nonunions. We performed rotator cuff repair and acromioplasty in 6 patients with rotator cuff injuries at same time.

The bone union was obtained in 26 patients, but not in one patient. Eighty nine% of patients were satisfied with the operative results. The average postoperative pain (VAS) was 0.1 at rest and 2.6 at maximal ROM. The limitations of motion compared with the unaffected side were; forward flexion 10 °, external rotation at the side 13 ° , internal rotation 3 thoracic spine difference and abduction 14 ° . The fracture type and the presence of nonunion did not affect shoulder pain or motion. The active patients had preferable results. Patients treated with rotator cuff repair and acromioplasty at same time had better results but there were not statistically significant.

Antegrade interlocking intramedullary nailing for the treatment of humeral shaft fracture showed excellent results, especially in for long spiral, comminuted and segmental humeral shaft fractures. However, it should be noted that early rehabilitation after stable fixation and a delicate and accurate surgical technique are important to obtain good shoulder motion and bone healing.