SummaryOperatively treated humeral fractures do not always heal. Failure of healing may result from technical errors, injury severity, infection, or limited patient regenerative capacity. Treating the humeral nonunion after failed initial fixation is often complicated by the original procedure. Fractured implants, bone loss, postoperative scarring, and osteopenia are all commonly present in these situations. Successful treatment requires solutions to all of these formidable problems in addition to a strategy that introduces stable fixation and osteogenesis. In the majority of situations, this is best accomplished with plate stabilization and cancellous bone grafting. Successful plate stabilization often requires modified techniques to deal with bone loss and osteopenia. These modifications include additional plate length, screw augmentation, bridge plating, and the use of fixed angle devices. Employing these strategies usually results in significantly improved function in these compromised patients.