Some evidence of bridging between fracture segments, some callus formation. ESF pins and IM pin intact.

Retrograde IM pin with two external skeletal fixator pins (positive
profile)
Prior to surgery an ultrasound-guided right brachial plexus block
was performed with 0.87mg bupivacaine. The patient was placed
in ventral recumbency with the right wing extended. Skin staples
were removed and the edge of the distal humeral bone fragment
was debrided with ronguers until healthy bone remained and hemorrhage
was present. The fragment was flushed with sterile saline, and
the proximal fragment was assessed similarly. An intramedullary
pin was carefully inserted into the proximal fragment and then
aligned and inserted into the distal fragment to better align
and appose both fragments. The skin was closed in a simple continuous
pattern. A 1.1 positive profile pin was inserted just proximal
to the humeral condyles, and a 1.6 positive profile pin was inserted
in the middle of the bone near the pectoral crest. 

Humeral rads. A craniolaterally displaced open, transverse, mid-diaphyseal fracture of the right humerus is appreciated. No fissures, comminution, or other fractures noted. The narrowest part of the humerus measures ~4.9mm, and the pectoral crest measures ~6mm. No other concerns are noted. 

Post-op right humeral fracture repair. An intramedullary pin is present in the medulla of the right humerus. An additional pin is positioned transverse through the pectoral crest and another through the distal humerus just proximal to the condyles.