Management of Radial Nerve Palsy Associated With Humerus Fracture

Prodromo, John; Goitz, Robert J.

doi:10.1016/j.jhsa.2013.02.003

Cited by 19 publications

(23 citation statements)

References 21 publications

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“…Total recovery was observed in 82.4 % of our patients. Apart from shorter time of recovery among secondary radial nerve palsy and type A fractures our findings seem to be consistent with those described in current literature [1,6,12,21].…”

Section: Discussionsupporting

confidence: 92%

“…The nerve is often found lacerated or entrapped between mobile bony fragments, in such cases early exploration is an absolute necessity [1,13,14]. In the case of low-energy trauma, radial nerve palsy is often caused by a nerve conduction block where the nerve is found macroscopically intact [6,14,15]. In recent years there has been a growing trend of cautious withholding until surgical treatment Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Time to recovery of primary and secondary radial nerve palsy depends on trauma mechanism, fracture type as well as the surgical management [3,6,12,19,21,24]. Shao et al published that the rate of spontaneous nerve recovery after secondary radial palsy was similar to that of primary radial palsy with an average time of onset of 7.3 weeks (2 weeks-6.6 months), the time of full recovery was reported with 6.1 months (3.4-12 months) [1].…”

Section: Discussionmentioning

confidence: 99%

“…The overall incidence of radial nerve palsy following humeral shaft fractures is about 2-18 %, in mean 12 % [4,5]. Due to different methods of fixation for humeral shaft fractures regarding closed or open fracture reduction, it is necessary to decide if early exploration in primary radial nerve palsy is indicated [4,6]. Thus open exploration facilitates fracture reduction and reduces damage by bony fragments and entrapment of the nerve [4,7].…”

Section: Introductionmentioning

confidence: 99%

“…Open or closed reduction of humeral shaft fractures is accompanied by resulting secondary radial nerve palsy in 6-12 % [8]. However, due to a high rate of spontaneous recovery, conservative treatment of radial nerve palsy and non operative fracture fixation have been postulated [6].…”

Section: Introductionmentioning

confidence: 99%

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Retrospective case series with one year follow-up after radial nerve palsy associated with humeral fractures

Lang

Ostermann

Arthold

et al. 2016

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to assess recovery and clinical outcome in patients with primary or secondary radial nerve palsy following humeral shaft fracture. Methods We retrospectively assessed 102 patients (45 female and 57 male) with humeral shaft fracture and concomitant radial nerve palsy, who were followed up for 12 months. Patients were divided into two groups with primary or secondary radial nerve palsy depending on the onset. Muscle function was measured according to Daniels classification and degree of nerve damage was assessed by the Sunderland classification. Results The average time for onset of recovery after primary RNP was 10.5 ± 3.31 weeks, in the case of secondary RNP it was 8.9 ± 7.98 weeks (p < 0.05). Full recovery or significant improvement was achieved with average of 26.7 ± 8.86 weeks and 23.9 ± 6.04 weeks respectively (p < 0.05). Trauma mechanism and type of treatment had no significant influence on time of onset of recovery or time to full recovery (p < 0.904). Conclusion Secondary RNP shows tendency for earlier recovery and is more commonly associated with ORIF.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Retrospective case series with one year follow-up after radial nerve palsy associated with humeral fractures

Lang

Ostermann

Arthold

et al. 2016

International Orthopaedics (SICOT)

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Radial nerve location at the posterior aspect of the humerus: an anatomic study of 100 specimens

Hackl

Damerow

Leschinger

et al. 2015

Arch Orthop Trauma Surg

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Distal locking technique affects the rate of iatrogenic radial nerve palsy in intramedullary nailing of humeral shaft fractures

Greiner

Kaiser

Kleiner

et al. 2022

Arch Orthop Trauma Surg

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Background Intramedullary humeral nailing is a common and reliable procedure for the treatment of humeral shaft fractures. Radial nerve palsy is a common complication encountered in the treatment of this pathology. The radial nerve runs from posterior to anterior at the lateral aspect of the distal humerus. Hence, there is reason to believe that due to the anatomic vicinity of the radial nerve in this area, lateral–medial distal locking in intramedullary nailing of the humerus may be associated with a greater risk for iatrogenic radial nerve injury compared to anterior–posterior locking. Questions/purpose To assess whether the choice of distal locking (lateral–medial versus anterior–posterior distal locking) in intramedullary humeral nailing of humeral shaft fractures affects the risk for iatrogenic radial nerve injury. Patients and methods Overall, 203 patients (116 females, mean age 64.3 ± 18.6 years), who underwent intramedullary nailing of the humerus between 2000 and 2020 at a single level-one trauma center, met the inclusion criteria and were analyzed in this retrospective case–control study. Patients were subdivided into two groups according to the distal locking technique. Results Anterior–posterior locking was performed in 176 patients versus lateral–medial locking in 27 patients. We observed four patients with iatrogenic radial nerve palsy in both groups. Risk for iatrogenic radial nerve palsy was almost 7.5 times higher for lateral–medial locking (OR 7.48, p = 0.006). There was no statistically significant difference regarding intraoperative complications, union rates or revision surgeries between both groups. Conclusions Lateral–medial distal locking in intramedullary nailing of the humerus may be associated with a greater risk for iatrogenic radial nerve palsy than anterior–posterior locking. Hence, we advocate for anterior–posterior locking. Level of evidence Level III retrospective comparative study.

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Management of Radial Nerve Palsy Associated With Humerus Fracture

Cited by 19 publications

References 21 publications

Retrospective case series with one year follow-up after radial nerve palsy associated with humeral fractures

Retrospective case series with one year follow-up after radial nerve palsy associated with humeral fractures

Radial nerve location at the posterior aspect of the humerus: an anatomic study of 100 specimens

Distal locking technique affects the rate of iatrogenic radial nerve palsy in intramedullary nailing of humeral shaft fractures

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