Case:
A 67-year-old woman presented 9 months after a closed midshaft humerus fracture with a new onset radial nerve palsy. Radiographs demonstrated a hypertrophic nonunion. Upon exploration, the radial nerve was in continuity and entrapped in fracture callus. It was extricated from the callus, and an open reduction and plate fixation was performed. Full radial nerve function returned by 3 months.
Conclusion:
We recommend that delayed onset radial nerve palsies be treated on a semiurgent basis with radial nerve exploration and decompression followed by internal fixation to achieve primary bone healing and minimize fracture callus formation.