Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

Hendrickx, Laurent A M; Hilgersom, Nick F. J.; Alkaduhimi, Hassanin; Doornberg, Job N.; Bekerom, Michel P.J. van den

doi:10.1007/s00402-020-03446-y

Cited by 36 publications

(36 citation statements)

References 62 publications

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“…In Humeral shaft fracture, radial nerve palsy (RNP) is not a surgical sign because it has a greater likelihood of healing spontaneously. Any vascular damage needing healing or bypasses, on the other hand, is an unequivocal criterion of surgical fracture treatment since the firm fixation preserves the vascular anastomosis [7]. The supine lying was preferred during operation.…”

Section: Methodsmentioning

confidence: 99%

Study on Percutaneous Intramedullary Nailing In Adult Diaphyseal Humeral Fractures

Soomro

Silro²,

Baloch³

et al. 2021

JPRI

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Objective: The objective of this research was to evaluate close fixation techniques for fractures of humerus via percutaneous intramedullary nailing. Methodology: This was a prospective study, carried out in Suleman Roshan Medical College Tando Adam Pakistan from January 2019 to January 2020. About 60 patients with humeral shaft fractures were made part of this study with a follow-up period of about 1 to 2 years. The inclusion criteria were humeral fractures that were of less than 7 days prior to surgery, the displacement of fracture >20° in sagittal as well as coronal plane, and the distance measuring >2cm between the two fragments. All patients were treated via the closed fixation technique. Multiple nails that were slender as well as flexible (3-5) were used in the close fixation technique including rush nails (45 patients) and ender nails (15 patients). All the patients within their follow-up periods were evaluated for ROM, pain, or any kind of deformity, and all the patients were assessed radiographically to check the process of bone union. Results: The outcome was analyzed before implant i.e at six months and after the implant was removed. About 86% patients (n= 52) revealed satisfactory outcomes at six months. About 5 patients revealed non-union or delayed union that was healed after 2nd surgery of bone grafting in 3 patients and injections associated with bone marrow in 2 patients. Stiffening of the shoulder was found to be a frequent complication that decreased significantly when the position of nail insertion was changed during the research. Conclusion: The technique of intramedullary nailing displayed many benefits including minimum tissue stress, a quick surgery time, decreased period of hospital stay, and rapid bone union.

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Section: Methodsmentioning

confidence: 99%

Study on Percutaneous Intramedullary Nailing In Adult Diaphyseal Humeral Fractures

Soomro

Silro²,

Baloch³

et al. 2021

JPRI

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“…The overall trial ow and timeline of data collection is outlined in Fig. 2 + Primary radial nervepalsy (RNP) is not an exclusion criterion as there has not been shown bene ts in recovery time with early exploration (28).…”

Section: Study Settingmentioning

confidence: 99%

Surgical Versus Non-Surgical Treatment of Humeral Shaft Fractures Compared By a Patient Reported Outcome: The Scandinavian Humeral Diaphyseal Fracture Trial (SHAFT) - A Study Protocol For a Pragmatic Randomized Clinical Trial

Karimi

Brorson

Midtgaard

et al. 2021

Preprint

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Background: The outcome of non-surgical treatment is generally good, but the treatment course can be long and painful with approximately a quarter of the patients acquiring a nonunion. Both surgical and non-surgical treatment can have disabling consequences such as nerve injury, infection and nonunion. The purpose of the study is to compare patient reported outcome after surgical and non-surgical treatment for humeral shaft fractures. Methods: A pragmatic randomized controlled trial is planned with two study groups (SHAFT-Y and SHAFT-E). A total of 287 eligible acute humeral shaft fractures are scheduled to be recruited and randomly allocated to surgical or non-surgical treatment with the option of early crossover due to delayed union. The surgical method within the allocation is decided by the surgeon. The primary outcome is the Disability of Arm, Shoulder and Hand (DASH) score at 52 weeks, and is assessor blinded. The secondary outcomes are DASH score, EQ-5D-5L, pain assessed by visual analogue score, Constant-Murley score including elbow range of motion and anchor-questions collected at all timepoints throughout the trial. All complications will be reported including; infection, nerve or vascular injury, surgical revisions (implant malpositioning, hardware failure, aseptic loosening and peri-implant fracture), major adverse cardiovascular events, and mortality. Patients declining randomization will be asked to enroll into an observational cohort with same outcomes and post-treatment regimes. Discussion: SHAFT will provide information on the effectiveness of two standard treatments for humeral shaft fractures, while taking the dilemmas within the population into account. Trial registration: Clinicaltrials.gov, NCT04574336. Registered on 5 October 2020.

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“…Fracture of the humerus usually results in radial nerve injury, it is the most common injury in humerus fracture. 1,2 The reason for the injury of the radial nerve is due to its close anatomical position about the humerus. The radial nerve is the terminal continuation of the posterior cord of the brachial plexus it contains nerve roots from C5-T1.…”

Section: Introductionmentioning

confidence: 99%

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

Khan¹,

Ali²,

Girma³

et al. 2022

J Ayub Med Coll Abbottabad

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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.

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Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

Cited by 36 publications

References 62 publications

Study on Percutaneous Intramedullary Nailing In Adult Diaphyseal Humeral Fractures

Study on Percutaneous Intramedullary Nailing In Adult Diaphyseal Humeral Fractures

Surgical Versus Non-Surgical Treatment of Humeral Shaft Fractures Compared By a Patient Reported Outcome: The Scandinavian Humeral Diaphyseal Fracture Trial (SHAFT) - A Study Protocol For a Pragmatic Randomized Clinical Trial

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

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