Wide Resection of Traction Induced Radial Nerve Injury with Cable Grafting Leads to Full Recovery
The specific clinical setting of high-energy open humerus fractures combined with radial nerve transection has typically led to poor final outcomes with respect to recovery of nerve function. Attention has focused on the issue of an expanded zone of nerve injury induced by longitudinal traction. The fundamental principle of nerve grafting is to bypass the zone of injury. If direct repair or short nerve grafts are placed within the zone of injury, limited recovery should be expected, and this is exactly what has been documented. Wide resection of the zone of traction induced injury, particularly from the distal injured nerve trunk and replacement with long cable grafts has the potential for improved outcomes. Complete nerve recovery to 5/5 manual motor power testing and bilaterally equivalent grip strength is reported in two initial cases treated according to the wide resection plan.
KeywordsRadial nerve graft Humerus fracture
- 3.Kallio PK, Vastamaki M, Solonen KA. The results of secondary microsurgical repair of radial nerve in 33 patients. J Hand Surg 1993;18B:320–22.Google Scholar
- 6.Ring D, Chin K, Jupiter JB. Radial nerve palsy associated with high-energy humeral shaft fractures. J Hand Surg 2004;29A:144–147.Google Scholar