Management of Humeral Shaft Fractures

Carroll, Eben A.; Schweppe, Mark; Langfitt, Maxwell K.; Miller, Anna N.; Halvorson, Jason J.

doi:10.5435/jaaos-20-07-423

Cited by 110 publications

(113 citation statements)

References 42 publications

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“…It has been postulated that earlier surgical intervention with ORIF leads to earlier recovery of radial nerve palsy [21,22]. Nevertheless, a relatively high incidence of secondary radial nerve palsy is associated with ORIF [19]. Still the question of correlation of bone union and recovery of radial nerve palsy remains unclear [14,16].…”

Section: Discussionmentioning

confidence: 99%

“…Both, ORIF and IN are well-established procedures with high rates of 85-93 % of recovery following primary radial nerve palsy [12,[17][18][19][20][21]. In the case of acute primary radial nerve palsy open reduction facilitates fracture treatment and enables simultaneous exploration of the radial nerve to determine the extent and the type of lesion [1,7,18].…”

Section: Discussionmentioning

confidence: 99%

“…Time to recovery of primary and secondary radial nerve palsy depends on trauma mechanism, fracture type as well as the surgical management [3,6,12,19,21,24]. Shao et al published that the rate of spontaneous nerve recovery after secondary radial palsy was similar to that of primary radial palsy with an average time of onset of 7.3 weeks (2 weeks-6.6 months), the time of full recovery was reported with 6.1 months (3.4-12 months) [1].…”

Section: Discussionmentioning

confidence: 99%

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Retrospective case series with one year follow-up after radial nerve palsy associated with humeral fractures

Lang

Ostermann

Arthold

et al. 2016

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to assess recovery and clinical outcome in patients with primary or secondary radial nerve palsy following humeral shaft fracture. Methods We retrospectively assessed 102 patients (45 female and 57 male) with humeral shaft fracture and concomitant radial nerve palsy, who were followed up for 12 months. Patients were divided into two groups with primary or secondary radial nerve palsy depending on the onset. Muscle function was measured according to Daniels classification and degree of nerve damage was assessed by the Sunderland classification. Results The average time for onset of recovery after primary RNP was 10.5 ± 3.31 weeks, in the case of secondary RNP it was 8.9 ± 7.98 weeks (p < 0.05). Full recovery or significant improvement was achieved with average of 26.7 ± 8.86 weeks and 23.9 ± 6.04 weeks respectively (p < 0.05). Trauma mechanism and type of treatment had no significant influence on time of onset of recovery or time to full recovery (p < 0.904). Conclusion Secondary RNP shows tendency for earlier recovery and is more commonly associated with ORIF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Retrospective case series with one year follow-up after radial nerve palsy associated with humeral fractures

Lang

Ostermann

Arthold

et al. 2016

International Orthopaedics (SICOT)

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“…In a series of diaphyseal fracture of humerus using titanium elastic nail and at the end of the study the authors concluded that the titanium elastic nails offer a number of potential advantage over traditional way of treating long bone fracture including early immobilization, shorter hospital stay and less risk of loss of fracture position [16]. In two comparative studies treating closed diaphyseal fractures humerus with elastic nail and plate osteosynthesis, the authors concluded that elastic stable nail is applicable for routine use in appropriate selected humerus shaft fracture [17,18].…”

Section: Discussionmentioning

confidence: 99%

Elastic Stable Intramedullary Nailing for Closed Diaphyseal Fractures of Humerus in Adults. A Case Series of 28 Patients

Kornah¹,

Soltan²,

Abdel-AAl³

2017

J Trauma Treat

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Aim of study: To demonstrate clinical and radiological effectiveness of intramedullary fixation of closed diaphyseal humeral fractures in adults using the elastic stable intramedullary nail (ESIN). Patients and methods:Between May 2011 and December 2013, twenty-eight patients (19 males) with closed diaphyseal humeral fractures treated with closed reduction and percutaneous fixation with 2 elastic stable nails. Age from 18 to 56 years (mean, 29 years). Patients with open or pathological fractures, those less than 18 years and medically unfit patients were excluded. Causative injury was pedestrian vehicular accident in 15, fall from height 9 and sport-related activity 4 patients. The time of surgical intervention varied from 24 to 72 hours post-injury. Results:Patients were followed up 12-31 months with an average of 20 months. X-ray films showed that twentysix fractures united completely at a range 14-20 week (mean, 13.1 weeks). Twenty-Six cases healed in good alignment at a median time of 13.1 weeks (range 14-20 weeks). One case developed delayed union where bone marrow injection and longer immobilization till full healing done. One case developed non-union which was treated by bone grafting and plating. There were no intraoperative complications. One patient with preoperative radial nerve injury recovered spontaneously by eight weeks. Patients followed and assessed using Disabilities of the Arm, Shoulder and Hand score (DASH). At last follow-up, the average DASH score was 90.5 (range 60-100). Final clinical evaluation showed 17 cases Excellent, 8 cases Good, 2 cases fair and one case Poor according to previous score. Conclusion:Elastic stable nail fixation is a good procedure for treating adult humeral shaft fractures in which stabilization is indicated as it provides stable fixation, with minimal soft tissue stripping at the fracture site and allows early mobilization of the extremity.

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“…[1,2] As is widely known, the most common injury associated with closed diaphyseal humeral fracture is the concomitant injury of the radial nerve. [3] The recent literature has suggested that closed fractures are frequently associated with neuropraxia of the radial nerve with spontaneous recovery expected in more than 80% of cases.…”

mentioning

confidence: 99%