Postoperative Radial Nerve Paralysis Caused by Fracture Callus

Edwards, Peter; Kurth, Lloyd A.

doi:10.1097/00005131-199206000-00017

Cited by 15 publications

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“…The site at which the nerve is most vulnerable to damage is near the junction of the middle and distal thirds of the humerus, as Holstein and Lewis [15], Bodner et al [4], and Edwards and Kurth [11] have described. Rates of permanent radial nerve palsy after a posterior approach to the humerus are approximately 0% to 3% [2,10,15].…”

Section: Introductionmentioning

confidence: 99%

Courses of the Radial Nerve Differ Between Chinese and Caucasians

Chou

Shyu

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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We analyzed anatomic distribution of the radial nerve in the upper arms in Chinese-adult embalmed cadavers (120 nerves in 60 cadavers) and compared it with findings reported for Caucasian adults. The acromion, the medial epicondyle, and the lateral epicondyle were used as bony landmarks. We used previously described techniques to quantitatively describe the location of the radial nerve in relation to the surrounding skeleton. Courses of the radial nerve relative to the humeral shaft in Chinese subjects differed from those previously reported for Caucasian subjects. The parameters that differed from Caucasians were: the distances from the acromion to the upper margin (147 ± 21 mm versus 124 ± 12 mm), the acromion to the lower margin (195 ± 36 mm versus 176 ± 17 mm), and the medial epicondyle to the lower margin (111 ± 21 mm versus 131 ± 10 mm). Our study provides information to help identify the radial nerve during surgery and elucidates racial differences in the distribution of the radial nerve between Chinese and Caucasian populations.

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Section: Introductionmentioning

confidence: 99%

Courses of the Radial Nerve Differ Between Chinese and Caucasians

Chou

Shyu

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…1 Over the past two decades, consensus has formed that a 3 months to 4 months period of watchful waiting is appropriate before surgical intervention is attempted. [1][2][3][4][5] The causes of secondary radial nerve palsy include trauma from fracture manipulation or surgery, impingement by or between fracture fragments, entrapment by fracture callus, 6 and scar tissue formation. Some authors think that any secondary radial nerve palsy is an indication for surgical exploration.…”

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confidence: 99%

Iatrogenic Radial Nerve Palsy After Operative Management of Humeral Shaft Fractures

Wang

Shen

Chen

et al. 2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…During re-exploration, the nerve was found to be transected and encased in the fracture callus. Rubbing of the nerve against the new bone was thought to be the mechanism of injury by the authors [9]. Ueda et al described a case in the Japanese literature of delayed onset radial palsy after 3 years from a humeral fracture treated by an intramedullary nail.…”

Section: Discussionmentioning

confidence: 99%

“…Secondary palsies are those that occur with closed reduction and manipulation or open reduction and internal fixation [4][5][6][7]. Only a few cases of late-onset radial palsy (not immediately associated with open reduction or closed manipulation) are reported in the literature [8][9][10]. We report a case of late-onset radial nerve palsy that occurred 2 months after closed, nonoperative treatment of a humerus fracture.…”

Section: Introductionmentioning

confidence: 99%

Late-Onset Radial Nerve Palsy Associated with Conservatively Managed Humeral Fracture. A Case Report and Suggested Classification System

Abdelgawad

Wassef

Ebraheim

2010

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Radial nerve palsy can occur with humerus fracture, either at the time of injury (primary) or during reduction (secondary). Late-onset radial nerve palsy (not immediately related to injury or reduction) has been very seldom reported in the English literature. We describe a case of late-onset radial nerve palsy, which developed 9 weeks after an attempted closed management of a midshaft humerus fracture. Exploration of the nerve was performed. The radial nerve was found to be stretched over the ends of the fracture. Open reduction and external fixation of the fracture with mobilization of the nerve from the fracture site lead to complete return of radial nerve function occurring by 3 months. We recommend exploration of cases of late-onset radial nerve palsy in contrast to primary or secondary radial nerve palsy, which can be treated conservatively. Our experience suggests that the cause of the palsy is a continuous ongoing pathology and not a single time event as in primary or secondary cases. Radial nerve palsies associated with humeral fracture should be classified as either primary (at the time of injury), secondary (at the time of reduction), or late onset (not related to either injury or reduction).

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Postoperative Radial Nerve Paralysis Caused by Fracture Callus

Cited by 15 publications

References 0 publications

Courses of the Radial Nerve Differ Between Chinese and Caucasians

Courses of the Radial Nerve Differ Between Chinese and Caucasians

Iatrogenic Radial Nerve Palsy After Operative Management of Humeral Shaft Fractures

Late-Onset Radial Nerve Palsy Associated with Conservatively Managed Humeral Fracture. A Case Report and Suggested Classification System

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