In this chapter we briefly discuss the role of plating, external fixators and intramedullary nailing in the management of diaphyseal humeral fractures. These three methods have a place in the armamentarium of the orthopaedist and rehire a clear understanding of their scientific rationale and techniques. The three methods have proven to be effective means of treatment and have remained the preferred ones for many surgeons who continue to use them in preference to other methods. As it is true for all available therapeutic modalities, none of the three methods is a panacea: infections may occur, nonunions are not uncommon, the need for removal of the implants frequent, and intraoperative complications not rare, such as nerve injury. Nonetheless, they are the preferred methods in the treatment for many fractures, particularly open ones associated with vascular of nerve injury, as well as in those patients with multiple injuries. It must be recognized, however, that despite the many advantages of the techniques, rigid immobilization of fractures is unphysiological because it delays healing and produces a callus with poor mechanical properties.