Frequency of Radial Nerve Injury in Patients With Closed Fracture of Humerus Shaft in High Energy Trauma Cases

Abstract

Background: Fracture of the humerus usually result in radial nerve injury. This study was done with the aim to determine the incidence of Radial Nerve Injury in patients with closed fracture of the humerus shaft in high-energy trauma cases. Methods: This descriptive study was conducted in the Department of Orthopedics and Emergency room, Ghurki Teaching Hospital, Lahore from January to December 2021 recruiting consecutive such patients. Standard ward protocol was followed to manage the patients initially including fracture stabilization and analgesia requirement. All the patients were carefully assessed to detect radial nerve injury. Data analysis was done through SPSS 26.0. Results: A total of 80 patients were included with the confirmed diagnosis of fracture of the humerus. There were 55(68.5%) males and 25(31.25%) females. The age range was 20 to 60 years and the mean age of males and females was 31.62±8.35 and 38.43±5.06 respectively with overall mean age±SD was 38.93±6.19. There were 32 (40%) cases of spiral fracture, 17 (21.25%) cases of transverse fracture, 16 (20%) cases of communized fracture, and 15 (18.75%) cases of segmental fracture. Radial nerve injury was present in 7 (8.75%) patients. Out of these 7 cases of radial nerve injury; 4 (57.1%) cases were recorded in patients with spiral closed fracture of midshaft of humerus, 1 (14.3%) cases were recorded in transverse closed fracture of humerus shaft, 1(14.3%) cases in comminuted closed fracture of midshaft of the humerus while 1 (14.3%) were segmental fractures. Conclusion: Our study highlighted the frequency of radial nerve palsy in humeral shaft cases with most common in spiral closed fracture of the midshaft of the humerus.

Median Nerve Palsy in Pediatric Supracondylar Humerus Fractures Recovers Faster With Open Than Closed Reduction

“…Multiple studies have reported the natural history of median nerve palsy after SCHF 3,17–20 . Although many median palsies after SCHF resolve quickly and spontaneously, several reports of long-term sequelae inconsistent with a neurapraxic injury exist 2,3,8–10,21 .…”

“…Multiple studies have reported the natural history of median nerve palsy after SCHF. 3,[17][18][19][20] Although many median palsies after SCHF resolve quickly and spontaneously, several reports of long-term sequelae inconsistent with a neurapraxic injury exist. 2,3,[8][9][10]21 Despite this, contemporary studies continue to describe SCHF-associated median nerve injury as neurapraxic in nature 4,7 when many have an axonotmetic component (Sunderland grade 2 or greater 22 ).…”

Treatment with methylphenidate and the risk of fractures among children and young people: A systematic review and self‐controlled case series study

“…Fractures have a negative impact on children and young people in multiple ways. [19][20][21][22][23][24][25] Given the increasing trend of methylphenidate uses all over the world over the past 20 years, 3,26 it is necessary to understand the relationship between the risk of fractures and methylphenidate use, to address the knowledge gap and to provide clinical guidance. Although several observational studies using between-subject design 17,18,27,28 have been conducted to investigate the association between the use of methylphenidate and the risk of fractures, they have yielded mixed results.…”

“…Although previous studies have demonstrated that the use of methylphenidate is associated with a lower risk of injury, 17,18 given the potential negative bone‐metabolic effect of methylphenidate, it is not clear if methylphenidate is associated with the risk of fractures. Fractures have a negative impact on children and young people in multiple ways 19–25 . Given the increasing trend of methylphenidate uses all over the world over the past 20 years, 3,26 it is necessary to understand the relationship between the risk of fractures and methylphenidate use, to address the knowledge gap and to provide clinical guidance.…”