Causes of Secondary Radial Nerve Palsy and Results of Treatment

Reichert, Paweł; Wnukiewicz, Witold; Witkowski, Jarosław; Bocheńska, Aneta; Mizia, Sylwia; Gosk, Jerzy; Zimmer, Krzysztof

doi:10.12659/msm.897170

Cited by 30 publications

(30 citation statements)

References 41 publications

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“…Out of these studies, we have extracted data of cases with secondary radial nerve injury for the study purpose. Four 5,9,12,13 were retrospective, and three 10,11,14 were prospective studies.…”

Section: Resultsmentioning

confidence: 99%

Is early exploration of secondary radial nerve injury in patients with humerus shaft fracture justified?

Vaishya

Kandel

Agarwal

et al. 2019

Journal of Clinical Orthopaedics and Trauma

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Background: Radial nerve is commonly injured with a fracture of the shaft of the humerus. Primary radial nerve injury occurs at the time of fracture, and secondary nerve injuries are seen after closed reduction or operative management. Management of these secondary nerve injuries is controversial regarding conservative approach verses early exploration. Materials and methods: The PubMed, Science Direct, Scopus, and Google Scholar were used to find out relevant studies in the English language from October 2007 to October 2017. After a search of total 114 articles, we excluded 107 articles which did not meet our inclusion criteria, and only seven studies were thoroughly reviewed. Results: Among the seven studies, three studies by Wang JP, Wang X, and Reichert P have included only secondary radial nerve injuries. Studies by Noaman H, Gouse M, Schwab TR and Bhardwaj A have included both primary as well as secondary radial nerve injury cases. Four studies used a conservative strategy and late exploration was advocated only if no nerve recovery was found within three to five months. Three studies recommended early radial nerve exploration (within the first two weeks) in patients with secondary radial nerve injury. Conclusions: The pattern and duration of radial nerve recovery in secondary nerve injury was similar to that seen in primary radial nerve palsy. No advantage was seen in the early exploration of the radial nerve in most of these studies. If there is no misplaced instrumentation, macroscopic laceration of nerve or fracture displacement in the postoperative radiograph, secondary radial nerve injury can be treated as a primary radial nerve injury, and we recommend observation for a minimum of four to five months before exploration.

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Section: Resultsmentioning

confidence: 99%

Is early exploration of secondary radial nerve injury in patients with humerus shaft fracture justified?

Vaishya

Kandel

Agarwal

et al. 2019

Journal of Clinical Orthopaedics and Trauma

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“…Others will advocate open reduction and exploration to prevent entrapment and iatrogenic laceration 3. Especially, in the ‘pink, pulseless hand’, a concurrent nerve palsy prompts early exploration as it is strongly predictive of nerve and vessel entrapment.…”

Section: Descriptionmentioning

confidence: 99%

Radial nerve palsy due to supracondylar open fracture in a child

Yoshida

Tsuchida

2017

BMJ Case Reports

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“…It is usually due to local pressure on the posterior aspect of the arm under anaesthesia, drug intoxication (i.e. alcohol) or profound sleep with the arm over a hard surface or under the body of somebody else (Honeymoon palsy) [118]. In most cases, it improves spontaneously [117].…”

Section: Radial Nerve (Rn) Entrapment Syndromesmentioning

confidence: 99%

Peripheral Nerve Entrapment and their Surgical Treatment

Vanaclocha‐Vanaclocha¹,

Saiz-Sapena²,

MaríaOrtiz‐Criado³

et al. 2017

Peripheral Nerve Regeneration - From Surgery to New Therapeutic Approaches Including Biomaterials and Cell-Based Therapies Deve

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Nerves pass from one body area to another through channels made of connective tissue and/or bone. In these narrow passages, they can get trapped due to anatomic abnormalities, ganglion cysts, muscle or connective tissue hypertrophy, tumours, trauma or iatrogenic mishaps. Nearly all nerves can be affected. The clinical presentation is pain, paraesthesia, sensory and motor power loss. The specific clinical features will depend on the affected nerve and on the chronicity, severity, speed and mechanism of compression.Its incidence is higher under some occupations and is some systemic conditions: diabetes mellitus, hypothyroidism, acromegaly, alcoholism, oedema and inflammatory diseases. The diagnosis is suspected with the clinical presentation and provocative clinical test, being confirmed with electrodiagnostic and/or ultrasonographic studies. Magnetic Resonance Studies (MRI) rule out ganglion cysts or tumours. Conservative medical treatment is often sufficient. In refractory ones, surgical decompression should be performed before nerve damage and muscle atrophy are irreversible. The 'double crash' syndrome happens when a peripheral nerve is compressed at more than one point along its trajectory. In cases with marked muscle atrophy, a 'supercharge end-to-side' nerve transfer can be added to the decompression. After decompression in those few cases with refractory pain, a nerve neurostimulator can be applied.

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Causes of Secondary Radial Nerve Palsy and Results of Treatment

Cited by 30 publications

References 41 publications

Is early exploration of secondary radial nerve injury in patients with humerus shaft fracture justified?

Is early exploration of secondary radial nerve injury in patients with humerus shaft fracture justified?

Radial nerve palsy due to supracondylar open fracture in a child

Peripheral Nerve Entrapment and their Surgical Treatment

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