Fractures of the humerus shaft are a common injury, mainly in younger patients and often coming with other injuries. The strategies of treatment are the conservative therapy, which was favoured till the late 1970s, and the operative therapy, including intramedullary nailing, plate osteosynthesis and external fixation. The initial procedure should be chosen according to the primary soft tissue damage and the existence of radial nerve palsy. The aim of treatment must be a usable extremity with anatomical axis, length and rotation.