Humeral shaft fractures account for approximately 7 % of all fractures in adults. They occur after direct trauma such as traffic accidents or after indirect, rotational trauma in sports accidents or falls at home. There are two peaks of incidence in the adult population: the young male and the older female. The first patient typically is the victim of high-energy trauma with multiple lesions, a more severe humeral fracture type and concomitant soft tissue damage. The latter patient suffers a solitary lesion and is the victim of a low-energy accident such as a fall from a standing or sitting position. The fracture type is then simple and there is no or minimal soft tissue damage. As pain is always severe and inability of use complete, there is an acute need of stabilization of the injured upper arm. Treatment modalities and principles have significantly changed during the last decades, as a response to the changing functional demands of the population and as a result of improvement of operative techniques and implants.