Radial nerve palsy can occur with humerus fracture, either at the time of injury (primary) or during reduction (secondary). Late-onset radial nerve palsy (not immediately related to injury or reduction) has been very seldom reported in the English literature. We describe a case of late-onset radial nerve palsy, which developed 9 weeks after an attempted closed management of a midshaft humerus fracture. Exploration of the nerve was performed. The radial nerve was found to be stretched over the ends of the fracture. Open reduction and external fixation of the fracture with mobilization of the nerve from the fracture site lead to complete return of radial nerve function occurring by 3 months. We recommend exploration of cases of late-onset radial nerve palsy in contrast to primary or secondary radial nerve palsy, which can be treated conservatively. Our experience suggests that the cause of the palsy is a continuous ongoing pathology and not a single time event as in primary or secondary cases. Radial nerve palsies associated with humeral fracture should be classified as either primary (at the time of injury), secondary (at the time of reduction), or late onset (not related to either injury or reduction).
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Pollock FH, Drake D, Bovill EG, Day L, Trafton PG (1981) Treatment of radial neuropathy associated with fractures of the humerus. J. Bone Jt. Surg. Am. 63(2):239–243
Shao YC, Harwood P, Grotz MR, Limb D, Giannoudis PV (2005) Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review. J. Bone Jt. Surg. Br. 87(12):1647–1652
Ekholm R, Adami J, Tidermark J, Hansson K, Törnkvist H, Ponzer S (2006) Fractures of the shaft of the humerus. An epidemiological study of 401 fractures. J. Bone Jt. Surg. Br. 88(11):1469–1473
Shaw J, Sakellarides H (1967) Radial-nerve paralysis associated with fractures of the humerus: a review of forty-five cases. J. Bone Jt. Surg. 49A:899–902
Kettelkamp D, Alexander H (1967) Clinical review of radial nerve injury. J. Trauma 7:424–432
Bostman O, Bakalim G, Vaniionpaa S, Wilppula E, Patiala H, Rokkanen P (1986) Radial palsy in shaft fracture of the humerus. Acta. Orthop. Scand. 57:316–319
DeFranco MJ, Lawton JN (2006) Radial nerve injuries associated with humeral fractures. J. Hand Surg. [Am]. 31(4):655–663
Chesser TJ, Leslie IJ (2000) Radial nerve entrapment by the lateral intermuscular septum after trauma. J. Orthop. Trauma. 14(1):65–66
Edwards P, Kurth L (1992) Postoperative radial nerve paralysis caused by fracture callus. J. Orthop. Trauma. 6(2):234–236
Ueda N, Susuki K, Tanigawa A, Kuroiwa Y, Obayashi O (2001) Delayed radial nerve palsy following a humeral shaft fracture. Rinsho Shinkeigaku. 41(6):322–324
Shah JJ, Bhatti NA. Radial nerve paralysis associated with fractures of the humerus. A review of 62 cases. Clin. Orthop. Relat. Res. 1983; (172): 171–176
Duthie HL (1957) Radial nerve in osseous tunnel at humeral fracture site diagnosed radiographically. J. Bone Jt. Surg. Br. 39-B(4):746–747
Amillo S, Barrios RH, Martínez-Peric R, Losada JI (1993) Surgical treatment of the radial nerve lesions associated with fractures of the humerus. J. Orthop. Trauma. 7(3):211–215
Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the reporting of this case, that all investigations were conducted in conformity with ethical principles of research.
About this article
Cite this article
Abdelgawad, A.A., Wassef, A. & Ebraheim, N.A. Late-Onset Radial Nerve Palsy Associated with Conservatively Managed Humeral Fracture. A Case Report and Suggested Classification System. HSS Jrnl 6, 49–51 (2010). https://doi.org/10.1007/s11420-009-9137-4
- radial nerve palsy
- humerus fracture
- external fixator
- late onset