Objectives: To evaluate the outcomes in patients treated for humerus distal third fractures with MIPO technique and visualization of the radial nerve by an accessory approach, in those without radial palsy before surgery. Methods: The patients were treated with MIPO technique. The visualization and isolation of the radial nerve was done by an approach between the brachialis and the brachiorradialis, with an oblique incision, in the lateral side of the arm. MEPS was used to evaluate the elbow function. Results: Seven patients were evaluated with a mean age of 29.8 years old. The average follow up was 29.85 months. The radial neuropraxis after surgery occurred in three patients. The sensorial recovery occurred after 3.16 months on average and also of the motor function, after 5.33 months on average, in all patients. We achieved fracture consolidation in all patients (M=4.22 months). The averages for flexion-extension and prono-supination were 112.85° and 145°, respectively. The MEPS average score was 86.42. There was no case of infection. Conclusion: This approach allowed excluding a radial nerve interposition on site of the fracture and/or under the plate, showing a high level of consolidation of the fracture and a good evolution of the range of movement of the elbow.226300303Tytherleigh-Strong, G., Walls, N., McQueen, M.M., The epidemiology of humeral shaft fractures (1998) J Bone Joint Surg Br., 80 (2), pp. 249-253Rockwood Jr, C.A., Green, D.P., Bucholz, R.W., Heckman, J.D., Rockwood and Greens fractures in adults. 7th ed. (2013), Philadelphia: Lippincott CoLivani, B., Belangero, W.D., Bridging plate osteosynthesis of humeral shaft fractures (2004) Injury., 35 (6), pp. 587-595Apivatthakakul, T., Arpornchayanon, O., Bavornratanavech, S., Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture (2005) Is it possible? A cadaveric study and preliminary report. Injury., 36 (4), pp. 530-538Hernández, S., Dario, R., Placa puente en húmero (2003) Perspectiva de una técnica. Rev Colomb Ortop Traumatol., 17 (3), pp. 69-73Livani, B., Belangero, W.D., Osteossíntese de fratura diafisária do úmero com placa em ponte: apresentação e descrição da técnica (2004) Acta Ortop Bras., 12 (2), pp. 112-117Livani, B., Belangero, W.D., Castro de Medeiros, R., Fractures of the distal third of the humerus with palsy of the radial nerve: management using minimally-invasive percutaneous plate osteosynthesis (2006) J Bone Joint Surg Br., 88 (12), pp. 1625-1628Ziran, B.H., Belangero, W., Livani, B., Pesantez, R., Percutaneous plating of the humerus with locked plating: technique and case report (2007) J Trauma., 63 (1), pp. 205-210Concha, J.M., Sandoval, A., Streubel, P.N., Minimally invasive plate osteosynthesis for humeral shaft fractures: are results reproducible? (2010) Int Orthop., 34 (8), pp. 1297-1305Holstein, A., Lewis, G.M., Fractures of the humerus with radial-nerve paralysis (1963) J Bone Joint Surg Am., 45, pp. 1382-1388Whitson, R.O., Relation of the radial nerve to the shaft of the humerus (1954) J Bone Joint Surg Am., 36 (1), pp. 85-88Wang, J.P., Shen, W.J., Chen, W.M., Huang, C.K., Shen, Y.S., Chen, T.H., Iatrogenic radial nerve palsy after operative management of humeral shaft fractures (2009) J Trauma., 66 (3), pp. 800-803Livani, B., Belangero, W., Andrade, K., Zuiani, G., Pratali, R., Is MIPO in humeral shaft fractures really safe? Postoperative ultrasonographic evaluation (2009) Int Orthop., 33 (6), pp. 1719-1723Kocher, T., Surgical approaches. (1987), p. 92. , In: Crenshaw AH, editor. Campbell's operative orthopaedics. 7th ed. St. Louis: Mosby CoMorrey, B.F., An, K.N., Chao, E.Y., Functional evaluation of the elbow (1993), pp. 86-89. , In: Morrey BF, editor. The elbow and its disorder. 2th ed. Philadelphia: WB SaundersPospula, W., Abu Noor, T., Percutaneous fixation of comminuted fractures of the humerus: initial experience at Al Razi hospital, Kuwait (2006) Med Princ Pract., 15 (6), pp. 423-426An, Z., Zeng, B., He, X., Chen, Q., Hu, S., Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique (2010) Int Orthop., 34 (1), pp. 131-135Zhiquan, A., Bingfang, Z., Yeming, W., Chi, Z., Peiyan, H., Minimally invasive plating osteosynthesis (MIPO) of middle and distal third humeral shaft fractures (2007) J Orthop Trauma., 21 (9), pp. 628-633Kobayashi, M., Watanabe, Y., Matsushita, T., Early full range of shoulder and elbow motion is possible after minimally invasive plate osteosynthesis for humeral shaft fractures (2010) J Orthop Trauma., 24 (4), pp. 212-216Lian, K., Wang, L., Lin, D., Chen, Z., Minimally invasive plating osteosynthesis for mid-distal third humeral shaft fractures (2013) Orthopedics., 36 (8), pp. e1025-e1032