Introduction: DHF can be effectively treated by either antegrade or retrograde IMIL nailing and these is a relatively novel method of fracture fixation. These comparative study of two approaches on DHF using the same locked nails. Materials and Methods: Our comparative study we have selected 97 patients with DHF. Out of 97 patients,70 male and 27 females, age ranging from 22 to 70 for males and 20 to 60 for females, 69 right and 17 left, 75 closed and 22 grade I & II compound fractures, RHN nailing was done on 47 and AHN was done on 50 patients. Results: We analyzed the objective and subjective outcome of RHN and AHN in 97 cases of DHF in various age groups. All fractures unite in good anatomic position. No cases of deep infections but in 1 case there was a posterior cortical break which hasn't altered his all union time which was average 12 weeks. Neurapraxia was developed in 3 cases of AHN and in 1 case of RHN and there was no nerve entrapment in RHN. In one case of DHF, there was abrasions at the site of proximal screw insertion so proximal locking wasn't done and it was found that more amount of callus was formed comparatively. So proximal locking wasn't done in RHN. Conclusion: IMIL nailing in the management of DHF is that a 'fixed' nail can be inserted with both antegrade and retrograde techniques regardless of the fracture pattern and location. RHN is long learning curve and should be done very meticulously because posterior cortical break can lead to disastrous situation.
Key words: RHN- retrograde humerus nailing, AHN- antegrade humerus nailing, DHF- diaphyseal humerus fracture, IMIL- intra-medullary inter-locking.