The Humeral Fracture with Radial Nerve Palsy: Is Exploration Warranted?

1972 ◽  
Vol 88 ◽  
pp. 34-38 ◽  
Author(s):  
John W. Packer ◽  
Robert R. Foster ◽  
Alexander Garcia ◽  
S Asiiby Grantham
Keyword(s):  
Radial Nerve ◽  
Nerve Palsy ◽  
Humeral Fracture ◽  
Radial Nerve Palsy

scholarly journals Iatrogenic Radial Nerve Palsy following Closed Reduction of a Simple Diaphyseal Humeral Fracture: Beware the Perfect X-Ray

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Morgan Jones ◽  
Hean Wu Kang ◽  
Christopher O’Neill ◽  
Paul Maginn
Keyword(s):  
Nerve Injury ◽  
Clinical Assessment ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Humeral Fracture ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Radial Nerve Palsy ◽  
X Ray ◽  
Radial Nerve Injury

Radial nerve injury is a recognised complication associated with humeral shaft fracture. A case of iatrogenic radial nerve injury is presented following fracture reduction. The relevant anatomy, challenges in management of humeral fractures with associated radial nerve injury, and the importance of detailed clinical assessment and documentation are discussed.

scholarly journals Managing Radial Nerve Injuries Associated with Humeral Fracture

2020 ◽  
Vol 71 (1) ◽  
pp. 400-404
Author(s):  
Vlad Carbunaru ◽  
Ana Maria Oproiu ◽  
Adrian Barbilian ◽  
Chen Feng-Ifrim ◽  
Alexandra Ciotei
Keyword(s):  
Nerve Injury ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Bone Fractures ◽  
Humeral Fracture ◽  
High Energy ◽  
Humeral Shaft ◽  
Long Bone ◽  
Radial Nerve Palsy ◽  
Radial Nerve Injury

The overall prevalence of radial nerve injury after humeral shaft fractures is up to 18% representing the most common peripheral nerve injury associated with long bone fractures. Spiral or oblique fractures of the junction between the middle and distal third of the humeral shaft are at greater risk for radial nerve injury. Iatrogenic damage to the radial nerve may also occur during manipulations of closed reduction. A prospective study between 2017-2019 following 5 patients (all male, with ages between 30 and 56 years old), who were treated at our clinic for complete radial nerve palsy after a high-energy fracture of the humerus. All the patients were followed-up for a mean of 6 months (range 4 - 15 months) post op. The first 3 cases showed the initial signs of recovery 4 weeks after the operation. In the last 2 cases a palliative radial intervention was required. The consequences of the radial nerve palsy associated with humeral fractures is strongly related to trauma mechanism. In high energy fractures, severe contusion or transection of the nerve must be expected. In this case, nerve recovery is unlikely and the patients should be informed of the poor prognosis and the need of tendon transfers.

scholarly journals OUTCOME OF THE CLOSED DIAPHYSEAL HUMERAL FRACTURE TREATED WITH DYNAMIC COMPRESSION PLATE

2018 ◽  
Vol 21 (05) ◽  
pp. 1021-1025
Author(s):  
Imran Khan Maher ◽  
Muhammad Ayub Laghari ◽  
Shakeel Ahmed Memon ◽  
Muhammad Saeed Arain
Keyword(s):  
Radial Nerve ◽  
Nerve Palsy ◽  
Dynamic Compression ◽  
Excellent Result ◽  
Humeral Fracture ◽  
University Hospital ◽  
Radial Nerve Palsy ◽  
Female Ratio ◽  
Dynamic Compression Plate ◽  
Compression Plate

Objective: To determine the treatment outcome of the closed diaphyseal humeralfracture treated with dynamic compression plate at Liaquat university hospital Hyderabad.Materials and methods: Total 30 patients having displaced diaphyseal humeral fracture wereincluded in the study. All the patients having fracture of less than 10 days and between the ages15 – 45 years were selected. All the patients selected after counseling and diagnosed as a caseof closed diaphyseal humeral shaft fracture on the basis of clinical examination and X-rays.In this study dynamic compression plates (DCP) were used for stabilization of humeral shaftfracture as assessed by pre operative workup, operative findings and outcomes were recordedwith postoperative complications. To avoid the radial nerve palsy it is isolated during operativeprocedure. Results: Present study was comprises of 30 patients with humeral fracture with themean age of 30.29±8.92 years and male/ female ratio of 7:3. On the radiological findings mostcommon type of fracture was oblique in 54%. From the complications, postoperative pain wasfound in 6.6% of the cases along with postoperative Infections in 10%. 90% fractures unitedwhile 10% fractures found with non union. Excellent result were seen in 60% of the cases, while30% cases were noted with satisfied results and very poor results were found in 10% of thecases. Conclusions: It is concluded that DCP is the good option for the fixation of diaphysealhumerus fracture. Radial nerve palsy is less likely if isolated during operation.

Humeral shaft fracture and radial nerve palsy in Korean soldiers: focus on arm wrestling related injury

2020 ◽  
pp. jramc-2019-001373
Author(s):  
Kyoung-Eun Kim ◽  
E-J Kim ◽  
J Park ◽  
SW Kim ◽  
J Kwon ◽  
...  
Keyword(s):  
External Force ◽  
Military Service ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Humeral Fracture ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Humeral Shaft Fractures

IntroductionHumeral shaft fractures can lead to radial nerve injury and may require surgery and rehabilitation. We determined the causative events of humeral fracture, including arm wrestling, in young Korean soldiers and examined whether humeral fracture is related to demographic characteristics and the presence of radial nerve palsy.MethodsWe reviewed 7.5 years (July 2012 to June 2019) of medical records covering patients who had experienced a humeral shaft fracture after entering military service and had received surgery for open reduction and internal fixation. Data were obtained on basic demographics, initial event provoking the fracture, presence of radial nerve palsy, initial and follow-up severity of the weakness, and any discharge from military service because of prolonged radial nerve palsy.ResultsOf 123 cases, arm wrestling was the leading cause (52.8%). A high energy injury, such as falling from a height (11.4%), and sports related slips (10.6%) were other causes. All humeral shaft fractures caused by forceful contraction were spiral, while 40% of the fractures caused by external force related events were of a transverse type. The percentage of left-sided fractures was significantly higher for fractures arising from an external force than in those caused by forceful contraction related events. Radial nerve palsy was found in 34 patients (27.6%), and 16 were discharged from the military because of prolonged radial nerve palsy 6 months after the fracture. The causative events and other factors did not affect the presence of radial nerve palsy.ConclusionArm wrestling was the leading cause of humeral fracture in young Korean soldiers but the chance of developing comorbid radial nerve palsy did not differ from that of other causes. These epidemiologic findings in this young active group may help in understanding the causes of humeral shaft fracture in soldiers and in the wider young population.

Radial Nerve Palsy: Nerve Transfer Versus Tendon Transfer to Restore Function

Hand ◽  
2021 ◽  
pp. 155894472098812
Author(s):  
J. Megan M. Patterson ◽  
Stephanie A. Russo ◽  
Madi El-Haj ◽  
Christine B. Novak ◽  
Susan E. Mackinnon
Keyword(s):  
Radial Nerve ◽  
Tendon Transfer ◽  
Nerve Palsy ◽  
Nerve Transfer ◽  
Pinch Strength ◽  
Radial Nerve Palsy ◽  
Nerve Injuries ◽  
Tendon Transfers ◽  
Nerve Transfers ◽  
Transfer Group

Background: Radial nerve injuries cause profound disability, and a variety of reconstruction options exist. This study aimed to compare outcomes of tendon transfers versus nerve transfers for the management of isolated radial nerve injuries. Methods: A retrospective chart review of 30 patients with isolated radial nerve injuries treated with tendon transfers and 16 patients managed with nerve transfers was performed. Fifteen of the 16 patients treated with nerve transfer had concomitant pronator teres to extensor carpi radialis brevis tendon transfer for wrist extension. Preoperative and postoperative strength data, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and quality-of-life (QOL) scores were compared before and after surgery and compared between groups. Results: For the nerve transfer group, patients were significantly younger, time from injury to surgery was significantly shorter, and follow-up time was significantly longer. Both groups demonstrated significant improvements in grip and pinch strength after surgery. Postoperative grip strength was significantly higher in the nerve transfer group. Postoperative pinch strength did not differ between groups. Similarly, both groups showed an improvement in DASH and QOL scores after surgery with no significant differences between the 2 groups. Conclusions: The nerve transfer group demonstrated greater grip strength, but both groups had improved pain, function, and satisfaction postoperatively. Patients who present early and can tolerate longer time to functional recovery would be optimal candidates for nerve transfers. Both tendon transfers and nerve transfers are good options for patients with radial nerve palsy.

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