 The advantages of open reduction and plate fixation of humeral shaft fractures include a direct approach to the fracture site with direct visualization and protection of the radial nerve depending on fracture level and approach, the possibility of rigid compressive fixation, and the opportunity for bone grafting andor radial nerve exploration if needed. Importantly, it permits rapid mobilization of the shoulder and elbow, obviating the need of immobilization, and ensures anatomic or near anatomic alignment. These advantages must be weighed against the small risk of infection 1-6 with most occurring after open fractures or severe crush injury, nonunion 4-6 especially in high energy injuries, and iatrogenic radial nerve injury 1-3 the vast majority of which are transient. 