Delayed Treatment of Persistent Radial Nerve Paralysis Associated with Fractures of the Middle Third of Humerus: Review and Evaluation of the Long-Term Results of 52 Cases

2007 ◽  
Vol 32 (5) ◽  
pp. 529-533 ◽  
Author(s):  
M. VERGA ◽  
A. PERI DI CAPRIO ◽  
M. A. BOCCHIOTTI ◽  
F. BATTISTELLA ◽  
S. BRUSCHI ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Radial Nerve ◽  
Humeral Fracture ◽  
Long Term Results ◽  
Nerve Paralysis ◽  
Surgical Exploration ◽  
Delayed Treatment ◽  
Nerve Grafts ◽  
Nerve Surgery

This study was undertaken to determine the efficacy of delayed surgical treatment in cases of persistent radial nerve paralysis after fractures of the middle third of the humerus. We have limited this study to patients who had absolutely no functional recovery of the radial nerve 3 to 4 months after middle third humeral fractures. The fractures were treated by a variety of orthopaedic methods, conservative and surgical, in other departments and hospitals. Surgical exploration of the radial nerve was carried out 3 to 4 months after primary orthopaedic treatment. The outcome of this study concurs with data in the literature in showing that delayed nerve surgery (neurolysis or nerve grafts) in the absence of functional recovery of the radial nerve after humeral fracture can be useful in achieving good functional recovery and subjectively satisfying results.

scholarly journals Internal Trauma, Humeral Fracture, and Radial Nerve Paralysis: How Could it Occur in the Sport Setting? A Case Report and Review of the Literature

2020 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Elghoul Naoufal ◽  
Elantri Ismail ◽  
Bouya Ayoub ◽  
Bennis Azzelarab ◽  
Zaddoug Omar ◽  
...  
Keyword(s):  
Radial Nerve ◽  
Full Range ◽  
Humeral Fracture ◽  
Imaging Findings ◽  
Review Of The Literature ◽  
Significant Morbidity ◽  
Nerve Paralysis ◽  
Pathologic Fractures ◽  
Type Of Fracture

Thrower’s fractures are Spiral fractures of the humerus in the ball. They represent very uncommon clinical entities that can simulate pathologic fractures. Moreover, the concomitant neurologic deficient is rare. Herein we report a 27 years old muscular man presented a spiral fracture of the humerus following a forceful throw of the ball during an amateur throwing challenge. Clinical and imaging findings showed a displaced Thrower fracture with radial nerve neurapraxia (known as Holstein Lewis fracture) prompting the patient to undergo surgery. The intraoperative aspect found that the nerve was near to the beveled distal humeral fragment with no incarceration. We performed an internal fixation using the Leicester plate and the nerve was kept away from the plate by the interposition of a soft tissue sheet. At the last follow up, the fracture united and radial nerve neurapraxia resolved and the patient regained the full range of motion of his right upper limb with no pain. In conclusion, although this type of fracture is rare, given their significant morbidity, we emphasize that the reactional throwers should undergo appropriate preseason training before practicing a throwing challenge or generally a throwing sport.

scholarly journals Long-term Results after Total Thyroidectomy in Patients with Graves' Disease in Uzbekistan: Retrospective Study

2011 ◽  
Vol 3 (2) ◽  
pp. 79-82
Author(s):  
Said I Ismailov ◽  
Nusrat A Alimjanov ◽  
Bakhodir Kh Babakhanov ◽  
Murod M Rashitov ◽  
Alisher M Akbutaev
Keyword(s):  
Postoperative Complications ◽  
Total Thyroidectomy ◽  
Thyroid Tissue ◽  
Long Term Results ◽  
Graves Disease ◽  
Nerve Paralysis ◽  
Treatment Groups ◽  
Institutional Experience

ABSTRACT Subtotal thyroidectomy has been advocated as the standard treatment for Graves' disease (GD) because of the assumed lower risk of complications compared with total thyroidectomy, and also it provides the chance to avoid thyroxin therapy. The present study aims to examine our institutional experience with total thyroidectomy for GD. Patients were divided into two surgical treatment groups: Total thyroidectomy (TT) (n = 97) and total thyroidectomy with intraoperative thyroid autotransplantation (TTITA) (n = 74). TTITA performed in 74 patients. 0.5 to 2 gm of thyroid tissue was cut into small pieces and autotransplanted into the forearm muscle of the patient. Postoperative complications included eight cases of RLN palsy, two patients had nerve paralysis, two patients underwent tracheostomy, transient hypoparathyroidism in 25 patients, permanent hypoparathyroidism in two cases, wound hemorrhage in two patients. TPOAb levels were increased in 9% of patients with TT whereas in patients with TTITA TPOAb concentrations were elevated in 65% of patients at 3 months follow-up. TRAb in patients with TT were not detected while 20% patients undergone TTITA had high TRAb levels and 13.3% had terminal concentrations at 3 months follow-up. Serum TPOAb and TRAb were detected in none of the patients who underwent TT and TTITA at 1, 3 and 5 years follow-up. Removal of all thyroid tissue offers the best chance of preventing recurrent hyperthyroidism and we saw no increase in postoperative complications in the TT group. We feel that TT is safe and superior for achieving the goal of treatment of Graves' disease.

Intracordal Injection of Autologous Fat in Patients With Unilateral Laryngeal Nerve Paralysis: Long-Term Results From the Patient???s Perspective

2003 ◽  
Vol 113 (3) ◽  
pp. 541-545 ◽  
Author(s):  
Ollivier Laccourreye ◽  
Jean-Fran??ois Papon ◽  
Romain Kania ◽  
Lise Crevier-Buchman ◽  
Daniel Brasnu ◽  
...  
Keyword(s):  
Laryngeal Nerve ◽  
Long Term Results ◽  
Nerve Paralysis ◽  
Autologous Fat ◽  
Laryngeal Nerve Paralysis

Long-Term Results of Tendon Transfers for Radial Nerve Paisy in Patients With Limited Rehabilitation

2000 ◽  
Vol 45 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Paul J. Skoll ◽  
Donald A. Hudson ◽  
Wikus de Jager ◽  
Martin Singer
Keyword(s):  
Radial Nerve ◽  
Long Term Results ◽  
Tendon Transfers

Long-Term Results of Tendon Transfers in Radial and Posterior Interosseous Nerve Paralysis

2006 ◽  
Vol 31 (5) ◽  
pp. 502-506 ◽  
Author(s):  
M. ROPARS ◽  
T. DRÉANO ◽  
P. SIRET ◽  
N. BELOT ◽  
F. LANGLAIS
Keyword(s):  
Nerve Palsy ◽  
Long Term Results ◽  
Posterior Interosseous Nerve ◽  
Nerve Paralysis ◽  
Abductor Pollicis Longus ◽  
Pronator Teres ◽  
Flexor Carpi Ulnaris ◽  
Posterior Interosseous Nerve Palsy

Eighteen cases of tendon transfer for isolated radial or posterior interosseous nerve palsy have been carried out in our unit over a period of 21 years. Fifteen patients were reviewed with a mean follow-up of 9.5 years. Nine had sustained high and six low radial nerve injury. We achieved 11 excellent, two good, one fair and one bad result. The main problems were loss of power of gripping and the occurrence of radial deviation, particularly in patients with flexor carpi ulnaris transfer to the extensor digitorum communis. During this time, our technique has evolved, including changes of the tendons transferred. Our final preference is a modified Tsuge procedure, using the pronator teres to restore extension of the wrist, the flexor carpi radialis for extension of the fingers and the palmaris longus for extension of the thumb. Abduction of the thumb is restored by a tenodesis of the abductor pollicis longus to the brachioradialis. This review justifies the final policy, in particular the preservation of flexor carpi ulnaris to maintain wrist stability and flexion.

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