Radial Nerve Injuries

Ljungquist, Karin L.; Martineau, Paul A.; Allan, Christopher H.

doi:10.1016/j.jhsa.2014.05.010

Cited by 56 publications

(47 citation statements)

References 37 publications

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“…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%

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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: Discussionmentioning

confidence: 99%

“…Humeral shaft fractures are often associated with radial nerve palsy, which represents the most common traumatic nerve injury [1][2][3]. The overall incidence of radial nerve palsy following humeral shaft fractures is about 2-18 %, in mean 12 % [4,5].…”

Section: Introductionmentioning

confidence: 99%

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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“…[12] Spontaneous recovery of neural functions after conservative management in some series has been reported as 70%. [9,13,14] Also, at early exploration, some authors found the nerve either lacerated or interposed between fragments to be as high as 47%. [14,15] These findings indicate that early exploration may be beneficial in a significant number of the cases.…”

Section: Discussionmentioning

confidence: 99%

Humeral shaft fractures and radial nerve palsy: early exploration findings

Yörükoğlu

Demirkan

Büker

et al. 2016

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu yazıda humerus cisim kırığıyla birliktelik gösteren radial sinir felçli olgularda erken dönem sinir eksplorasyonunun sonuçları sunuldu ve hangi olgularda erken sinir eksplorasyonunun faydalı olabileceği araştırıldı. Hastalar ve yöntemler: Humerus cisim kırığına eşlik eden tam duyu ve motor radial sinir hasarı olan 24 hasta (17 erkek, 7 kadın; ort. yaş 36 yıl; dağılım 18-72 yıl) retrospektif olarak incelendi. Yüksek enerjili travmalı hastalar ile spiral ve parçalı kırığı olan düşük enerjili travmalı hastalar çalışmaya alındı. Tüm hastalara sinir eksplorasyonu kırık oluşumu sonrası ortalama 4.8 günde (dağılım 1-20 gün) uygulandı. On ikinci haftaya kadar nörolojik iyileşme olmayan hastalara elektrofizyolojik değerlendirmeler uygulandı. Bulgular: Ameliyat edilen 24 hastanın 14'ünde (%58.3) görülen spiral humerus cisim kırıkları en yaygın kırık tipi idi; bunu dört hastada transvers (%16.6) ve iki hastada (%8.3) parçalı kırık izledi. Eksplorasyon sonucu yedi hastada (%29.1) sinirin kırık fragmanları arasında sıkışmış olduğu görüldü; bu hastaların çoğunluğu (n=6) spiral humerus kırıklı idi, bir hastada ise parçalı kırık vardı. Spiral tip kırığı olan bir hastada sinir transeksiyonu vardı. Hastaların çoğunluğunda (%95.8) radial sinir fonksiyonları iyileşti. Kırık kaynama süresi ortalama 6.7±3.8 ay (dağılım 3-18 ay) idi. Sonuç: Spiral humerus kırıkları, özellikle kama fragmanlı olanlar, erken cerrahi eksplorasyon için aday olabilir. Erken dönem eksplorasyonu spiral ve parçalı humerus kırığına eşlik eden radial sinir disfonksiyonlu hastalarda sinir hasarının erken saptanması açısından faydalı olabilir.Anahtar sözcükler: Humerus kırığı, sinir ezilmesi, periferik sinir hasarları, radial nöropati. ABSTRACTObjectives: This study aims to present the results of early nerve explorations in cases with radial nerve palsy associated with humeral shaft fracture and to investigate in which cases early nerve explorations may be beneficial. Patients and methods: Twenty-four patients (17 males, 7 females; mean age 36 years; range 18 to 72 years) with complete sensory and motor radial nerve damage associated with humeral shaft fracture were retrospectively analyzed. The patients with high-energy trauma and the ones who had spiral and segmental fractures with low energy traumas were included in the study. Early nerve exploration was performed in all patients within an average of 4.8 days (range 1 to 20 days) after fracture development. Electrophysiological assessments were performed in cases with no neurological recovery until 12 th week.Results: Spiral fractures of the humerus shaft observed in 14 (58.3%) of the 24 operated patients were the most common fracture type, followed by transverse fracture in four patients (16.6%) and comminuted fracture in two patients (8.3%). As a result of the exploration, we observed nerve compression between the fracture fragments in seven patients (29.1%); a majority of these patients (n=6) had spiral fractures of humerus and one patient had comminuted fracture. One patient with a spiral type fr...

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“…If a follow-up electrodiagnostic study at the 12-week point shows similar findings as the baseline, then exploration may be indicated [36]. Although the optimal timing of deferred exploration is still debated, many authors consider 4-6 months to be an appropriate length of time for expectant management [5,25,27,37] based on the patient's clinical course [38] and the evidence that poor functional recovery due to decreased motor neuron regeneration capacity was demonstrated already after 7-8 weeks [39,40].…”

Section: Clinical Observationmentioning

confidence: 99%

Humerus shaft fracture complicated by radial nerve palsy: Is surgical exploration necessary?

et al. 2016

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Fractures of the humerus shaft often are complicated by radial nerve palsy. Controversy still exists in the treatment that includes clinical observation and eventually late surgical exploration or early surgical exploration. Algorithms have been proposed to provide recommendations with regard to management of the injuries. However, advantages and disadvantages are associated with each of these algorithms. The aim of this study was to analyze the indications of each treatment options and facilitate the surgeon in choosing the conduct for each lesion, proposing our own algorithm.

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Radial Nerve Injuries

Cited by 56 publications

References 37 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

Humeral shaft fractures and radial nerve palsy: early exploration findings

Humerus shaft fracture complicated by radial nerve palsy: Is surgical exploration necessary?

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