A, Closed midshaft right humeral shaft fracture. B, Planned incision for 14-hole plate. C, Two incisions on anterior arm connected by a submuscular extraperiosteal tunnel. D, Proximal 4- to 5-cm incision at level of pectoralis major insertion, with cephalic vein preserved. E, Distal 4- to 5-cm incision proximal to antecubital crease; lateral antebrachial cutaneous nerve identified beneath biceps. F, Provisional reduction and alignment after plate insertion. G, Plate contoured to match normal anterior humeral cortical surface. H, Plate internally rotated 15 to 20 degrees through its midportion, consistent with normal anatomy. (From Tetsworth K, Hohmann E, Glatt V: Minimally invasive plate osteosynthesis of humeral shaft fractures: current state of the art, J Am Acad Orthop Surg 26:252, 2018.) SEETECHNIQUE 57.8.