Primary exploration for radial nerve palsy associated with unstable closed humerus shaft fracture

Han, Soo-Hong; Hong, In Tae; Lee, Ho Jae; Lee, Sang June; Kim, Uk; Kim, Dong Won

doi:10.5505/tjtes.2017.26517

Cited by 5 publications

(9 citation statements)

References 26 publications

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“…Seventeen studies provided data on humeral shaft fractures in their population [3,5,7,9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Five studies provided information regarding findings at exploration but did not provide background epidemiological fracture data [8,10,22,[25][26].…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Two studies recommended early exploration for secondary radial nerve palsies [7,22]. Three studies favored early exploration for fractures undergoing ORIF [8][9]23]. Four studies advocated early exploration in high-energy mechanisms of injury with a concomitant primary radial nerve palsy [9,[22][23]26].…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…The rate of recovery seen with exploration and nerve interventions increases the overall rate of recovery to 88.1%, with a mean follow-up time of 30.1 months (5.5-80) [4]. While the majority of studies support expectant management for all radial nerve palsies that occur in closed humeral shaft fractures, there are proponents who advocate for early surgical exploration [2,[7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review

Hegeman

Polmear

Nesti

et al. 2020

Cureus

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Radial nerve palsies in closed humeral shaft fractures are common, with an incidence of 7%-17%. The management of radial nerve palsies in closed fractures is often expectant, with 70.7% spontaneously recovering within six months. A literature search was conducted for studies on radial nerve palsies in humeral shaft fractures from 2000-2018. A total of 4972 humeral shaft fractures were identified, with an incidence of 12.2% of primary radial nerve palsies. During the exploration, no neurological intervention was performed in nearly 41% of cases, and the most common finding was no evidence of any nerve lesion (35%). Those who underwent neurolysis were more likely to resolve when compared to primary repair or nerve grafting. Overall, there was a high rate of spontaneous radial nerve palsy recovery (85%) with radial nerve exploration increasing rates of resolution. While exploration demonstrates increased resolution, it is yet to be determined which fractures are indicated for nerve exploration.

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Section: Characteristics Of Studiesmentioning

confidence: 99%

Section: Characteristics Of Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review

Hegeman

Polmear

Nesti

et al. 2020

Cureus

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“…After an average follow-up of 51.7 months, only one of the nine patients continued to have partial radial nerve injury (11.2%). When examined the literature, we found a similar healing rate of radial nerve injury [2,8]. We could not find in the literature any study examining the effect of RNI on fracture healing.…”

Section: Discussionmentioning

confidence: 66%

“…For this reason, it is very important for the assistant health personnel to be attentive in the surgery of distal humerus fractures. Since the spontaneous recovery rate of nerve injury after the radial nerve injury varies from 70% to 100%, nerve exploration after RNI is a controversial issue [3,[7][8][9] The operation of our patients in our study was performed not to control nerve injury, but with open reduction due to the need for surgery.…”

Section: Discussionmentioning

confidence: 99%

Researching the effect of radial nerve injury in humerus shaft fractures

2020

Ann Clin Anal Med

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Aim: Radial nerve injury (RNI) is a frequently encountered condition in distal humeral shaft fractures. However, few studies have researched the effect of RNI on fracture healing and extremity functions in patients. In this study, we examined the fracture union time and functional results of the extremity in patients with humerus shaft fracture and RNI. Material and Methods: Thirty patients who underwent osteosynthesis with plaque due to 1/3 distal shaft fracture were included in our clinic between 2012 and 2019. We divided the patients with at least 12 follow-ups with and without RNI into two groups. We compared the union time of the fractures of these groups and their functional results after the fracture healing. We used the Disabilities of Arm, Shoulder and Hand (DASH) questionnaire for upper extremity function measurement. Results: Nine (30%) out of 30 patients had RNI. Fractures of 28 patients (93.3%) were healed without the need for a second operation. Eight (88.8%) out of 9 patients with RNI demonstrated complete healing and 1 patient (11.2%) partial healing. No significant difference was found in patients with and without RNI in terms of fracture union time. DASH scores of patients with RNI were worse than patients without RNI. Discussion: Although isolated RNI developed after humerus fracture does not negatively affect fracture healing rate and time, RNI developing after fracture negatively affects functional results of upper extremity.

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Need for early exploration of radial nerve in humeral shaft fractures with radial nerve palsy

Moon

Gwark

et al. 2020

Arch Orthop Trauma Surg

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Primary exploration for radial nerve palsy associated with unstable closed humerus shaft fracture

Cited by 5 publications

References 26 publications

Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review

Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review

Researching the effect of radial nerve injury in humerus shaft fractures

Need for early exploration of radial nerve in humeral shaft fractures with radial nerve palsy

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