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

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Radial nerve palsy (RNP) associated with humeral shaft fracture (HSF) is the most common nerve complication in long bone fractures. There is still controversy over the need for immediate exploration of the radial nerve (RN) in HSF with RNP. The purpose of the current study was to determine which situations of HSF with RNP require early exploration of the RN.

Materials and methods

This is a retrospective study that included 55 patients who had visited the emergency department of the current authors’ hospital and had been diagnosed with HSF between March of 2005 and September of 2015. Of these 55 patients, 14 (25.4%) had been diagnosed with HSF with RNP. We reviewed the medical records of those 14 patients and their radiographs to evaluate each fracture’s type, location, pattern, energy of trauma, status of RN injury, and time until recovery from RNP.

Result

All the 14 RNP patients had suffered high-energy trauma. Three had fractures in the proximal third (21.4%), six in the middle third (42.9%), and five in the distal third (35.7%). The three patients (21.4%) with incomplete recovery of RNP all had proximal third fractures; two of these three patients had RN transection.

Conclusion

Early exploration of the radial nerve should be considered in patients with radial nerve palsy associated with proximal third humeral shaft fracture, regardless of the fracture patterns caused by the high-energy trauma.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro Seongsan-gu, Changwon, 51472, Republic of Korea

    Jin-Hyung Im, Ji-Yong Gwark & Hyung Bin Park

  2. Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Republic of Korea

    Dong Kyu Moon

  3. Institute of Health Science and School of Medicine, Gyeongsang National University, Jinju, Republic of Korea

    Hyung Bin Park

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  1. Jin-Hyung Im
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Correspondence to Hyung Bin Park.

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The present study was a retrospective study using medical data and radiologic exam after approval by Institutional Review Board of the author’s hospital (No. GNUH-2016-07-001).

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Im, JH., Moon, D.K., Gwark, JY. et al. Need for early exploration of radial nerve in humeral shaft fractures with radial nerve palsy. Arch Orthop Trauma Surg 141, 1189–1195 (2021). https://doi.org/10.1007/s00402-020-03580-7

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