The choice of plate position depends on the fracture morphology and location, the radial nerve pathology and the surgeon’s preference. The anterolateral, anterior, and posterior surfaces of the humeral shaft are all possible choices.
The medial surface is generally only used for complex reconstructive procedures, ie vascular repair in complex fractures. Since the use of this plate position is rare it is not further shown.
The location should allow sufficient plate length on both proximal and distal segments, with a minimum of three holes for each.
For optimal compression, the plate should be positioned so that an “axilla” with one of the two fragments can be formed.
If the fracture location and orientation is suitable for lag screw fixation, consider applying a lag screw through the plate.
Be aware, that due to the soft-tissue attachments the optimal plate position for compression plating cannot always be obtained. In this case, it may be preferable to use lag screw(s) and a neutralization plate or bridge plating with locking plates to reduce soft-tissue dissection.