Radial palsy in shaft fracture of the humerus

Abstract

Fifty-nine patients with immediate and 16 with secondary radial nerve palsy complicating a fracture of the shaft of the humerus were reviewed. According to the preferences of the surgeon in charge, the palsy was treated either with early exploration of the radial nerve and internal fixation of the fracture or with initial expectance. Of the latter, 12 were later explored. No useful recovery of motor function could be seen in 13/59 patients with immediate and in 2/16 patients with secondary palsy. In patients with immediate palsy treated by early exploration, there were 8/27 nonrecoveries. Among those treated with initial expectance, there were 5/32 nonrecoveries. For secondary palsy, these figures were 2/10 and 0/6, respectively. No support emerged for routine early exploration.

Outcome of radial nerve injury associated with fracture humeral shaft fractures treated with open reduction and internal fixation

“…Fracture pattern was oblique in 40% cases, transverse in 32%, spiral in 16% and comminuted in 12% of our series cases. This is in accordance with other series [11][12][13][14][15][16][17][18][19][20][21] . Comminution, signifying high energy absorption by the limb segment at the site of direct injury may result in direct radial nerve damage whereas the transverse fracture commonly angulated laterally may be responsible for indirectly damaging the radial nerve by either impingement by sharp fracture fragment or sudden stretching across the fracture site angulation.…”

“…Comminution, signifying high energy absorption by the limb segment at the site of direct injury may result in direct radial nerve damage whereas the transverse fracture commonly angulated laterally may be responsible for indirectly damaging the radial nerve by either impingement by sharp fracture fragment or sudden stretching across the fracture site angulation. In all our cases, nerve was found to be in anatomical continuity and hence no surgical repair was done as with other series [11][12][13][14][15][16][17][18][19][20][21] . The union in our series was achieved in all 25 patients, at mean on 16.2 weeks with mean DASH score of 21.2 and with 88% patient showing excellent to good outcome.…”

“…No [17] 62 3 19 53 9 0 Bostman et al [18] 75 6 43 60 15 0 Foster et al [19] 14 7 7 9 4 1 Larsen et al [20] 26 1 4 26 0 0 Ring et al [21] …”

Cupping Therapy Combined with Rehabilitation for the Treatment of Radial Palsy: a Case Report

“…Nerve damage occurs rarely after radial shaft fractures. The radial nerve can be damaged primarily (due to trauma), or through secondary (iatrogenic) damage following surgical investigation [8] as was observed in the present case.…”

“…Detection of reinnervation potential within 6-8 weeks supports a diagnosis of axonotmesis. However, if reinnervation potential is not detected, then the nerve damage is classified as neurotmesis and requires surgical exploration [8]. The decision on whether nerve damage requires surgery is controversial [9].…”