الفهرس 
1-Acknowledgement.Only 14 pages are availabe for public view
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Abstract
Several features about the humerus cause fractures of that bone to present special attention in treatment make it necessary to depart from common lines of treatment of fractures of long bones. These features are:
• It is the most freely movable long bone and its movement can be amplified by the movement of the scapula. So it can overcome wide range of malalignment and malrotation.
• Its entire function is that of a lever, so that nearly all stress is in tension or at an angle to its long axis.
• The bone has to stand comparatively little stress in compression.
• When at rest while the person is standing, the axis of the bone hangs vertically and is influenced by gravity alone, this can be used effectively for treatment.
• It is a single bone, well enclosed in soft tissues (mainly muscles) which give very good vascular supply and can mask malunion in any plane with acceptable cosmetics.
• Fractures of bones with a rich blood supply, such as the rib, femur or humerus, where there is slight motion at the fracture site, usually heal rapidly, provided that there is no infection or mechanical interference, such as excessive trauma, soft tissue interposition, or gross malposition.
• The acceptable alignment is:
<20° anteroposterior.
<30° varus or valgus.
• With very good functional outcome because of wide range of movement in the upper limb which canbe overcome these deformity.
from these features we can conclude that:
In fracture humerus, like fracture clavicle, neither rigid immobilization nor perfect alignment are of great importance for final outcome of the fracture. So conservative treatment is the most effective way of treatment and the operative treatment can has adverse effect on the outcome in case of bad judgment and should be limited as much as possible to these indications, vascular and nerve injury, patients with multiple fractures, bilateral humeral shaft fractures, pathological fractures, comminuted segmental fractures and open fractures.
Recommendations: Because of the high union rate and good to excellent functional outcome we recommend conservative treatment for fracture shaft humerus as treatment of choice and to operate only in the presence of strict indications.