Radial and Axillary Nerves

Bono, Christopher M.; Grossman, Mark G.; Hochwald, Neal; Tornetta, Paul

doi:10.1097/00003086-200004000-00032

Cited by 160 publications

(14 citation statements)

References 8 publications

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“…Bono et al, 15 however, localized it closer to the middle of the humerus. According to their study the radial nerve transverses the lateral intermuscular septum at 17.0 Ϯ 2.3 cm (range, 13.0 -22.0 cm) from the proximal humerus (53% of the humeral length), at 12.0 Ϯ 2.3 cm (range, 7.4 -16.6 cm) from the olecranon fossa (36% of the humeral length), and at 16.0 Ϯ 0.4 cm (range, 9.0-20.5 cm) from the distal humerus (47% of the humeral length), which represents the approximate midpoint of the bone.…”

Section: The Humerusmentioning

confidence: 99%

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Radial Nerve Injuries Associated With Humeral Fractures

DeFranco

Lawton

2006

The Journal of Hand Surgery

116

106

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Section: The Humerusmentioning

confidence: 99%

“…Overall, the radial nerve crosses the lateral intermuscular septum more proximally than previously reported; it travels along a superficial course in the entire distal half of the humerus. 15 These data may have important implications in defining fracture patterns associated with radial nerve injuries and appropriate management.…”

Section: The Humerusmentioning

confidence: 99%

Radial Nerve Injuries Associated With Humeral Fractures

DeFranco

Lawton

2006

The Journal of Hand Surgery

116

106

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“…Also, since the plate is positioned on the lateral side of the humerus, visibility is limited [11]. An extended anterolateral deltoid-splitting approach can be performed; however, there is a possibility of axillary nerve injury with this approach [19]. Hepp et al [13] reported that this approach had better clinical outcomes compared to the deltopectoral approach due to the deltoid injury occurring in the operation process.…”

Section: Discussionmentioning

confidence: 99%

Comparison between minimally invasive plate osteosynthesis and the deltopectoral approach with allogenous fibular bone graft in proximal humeral fractures

Kim¹,

Lee

Kim

2020

Clin Shoulder Elbow

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Background: Both allogenous fibular bone graft and minimally invasive plate osteosynthesis have been developed to reduce issues such as fixation failure, displacement, angulation, and nonunion after plate fixation of proximal humeral fractures. However, there have been no studies investigating the differences in clinical results between these methods. The purpose of this study was to investigate the clinical differences between open reduction and plate fixation via a deltopectoral approach with allogenous fibular bone graft and a minimally invasive approach, in Neer's classification two-, three-part proximal humeral fractures.Methods: In this retrospective study, 77 patients with Neer classification two-, three-part proximal humeral fractures were treated at two different institutions. Clinical and radiological evaluations were performed in 39 patients who underwent minimally invasive plate osteosynthesis at one institution (group A) and 38 patients who underwent the deltopectoral approach with allogenous fibular bone graft at another institution (group B). The results between the groups were compared.Results: The minimally invasive plate osteosynthesis procedure (group A) was significantly less time- consuming and caused less bleeding than allogenous fibular bone graft through a deltopectoral approach (group B) (P<0.05). The duration of the fracture union was significantly reduced in group A (14.5±3.4 weeks; range, 10–22 weeks) compared to group B (16.4±4.3 weeks; range, 12–28 weeks) (P<0.05). There were no statistically significant differences between the two groups when evaluating the visual analog scale and Constant scores 1 year postoperatively. Radiological evaluation including neck-shaft angle and plate height were measured on the final follow-up X-ray image. There was no difference in radiological outcomes between the two groups. There were no statistically significant differences in malunion between the two groups; there were three malunion cases (7.7%) in group A and four (10.5%) in group B.Conclusions: The minimally invasive plate osteosynthesis procedure and deltopectoral approach with allogenous fibula bone graft for Neer's classification two-, three-part proximal humeral fractures demonstrated similar clinical and radiological results. However, allogenous fibula grafts require longer surgery, cause more bleeding, and result in longer fracture healing time than the minimally invasive plate osteosynthesis procedure.

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“…Humeral shaft fractures are commonly associated with lesions of the radial nerve. The anatomical proximity and association of the bone and nerves in the humeral shaft explain the incidence of between eight and 12 % [34, 35]. We documented primary radial nerve palsy in twelve of the 58 patients (20.7%).…”

Section: Discussionmentioning

confidence: 99%

Open reduction and internal fixation of humeral midshaft fractures: anterior versus posterior plate fixation

Lotzien

Hoberg

Rausch

et al. 2019

BMC Musculoskelet Disord

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BackgroundFractures of the humeral shaft represent 2–4% of all fractures. Fractures of the humerus have traditionally been approached posteriorly for open reduction and internal fixation. Reports of treating midshaft fractures with an open anterolateral approach and anterior plating are limited. The purpose of this study was to evaluate a series of humeral shaft fractures treated with plate osteosynthesis regarding the effect of the approach and plate location on the healing rate and occurrence of complications.MethodsWe conducted a retrospective chart review of patients aged over 18 years with humeral midshaft fractures treated with anterior or posterior plate fixation. Selection of the approach to the humerus was based on the particular pattern of injury and soft tissue involvement. The minimum follow-up duration was set at six months. The outcomes included the rate of union, primary nerve palsy recovery, secondary nerve damage, infection and revision surgery.ResultsBetween 2006 and 2014, 58 patients (mean age, 59.9; range, 19–97 years) with humeral midshaft fractures were treated with anterior (n = 33) or posterior (n = 25) plate fixation. After a mean follow-up duration of 34 months, 57 of 58 fractures achieved union after index procedure. Twelve fractures were associated with primary radial nerve palsy. Ten of the twelve patients with primary radial palsy recovered completely within six months after the index surgery. In total, one patient developed secondary palsy after anterior plating, and three patients developed secondary palsy after posterior plating. No significant difference in the healing rate (p = 0.4), primary nerve palsy recovery rate (p = 0.6) or prevalence of secondary nerve palsy (p = 0.4) was found between the two clinical groups. No cases of infection after plate fixation were documented.ConclusionsOpen reduction and internal fixation using an anterior approach with plate fixation provides a safe alternative to posterior plating in the treatment of humeral shaft fractures. An anterior approach allows supine positioning of the patient and yields union and complication rates comparable to those of a posterior approach with plate fixation for the treatment of humeral shaft fractures.

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Radial and Axillary Nerves

Cited by 160 publications

References 8 publications

Radial Nerve Injuries Associated With Humeral Fractures

Radial Nerve Injuries Associated With Humeral Fractures

Comparison between minimally invasive plate osteosynthesis and the deltopectoral approach with allogenous fibular bone graft in proximal humeral fractures

Open reduction and internal fixation of humeral midshaft fractures: anterior versus posterior plate fixation

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