Nerve Injury During Treatment of the Proximal Humerus Fracture

Abstract

Nerve injuries, next to vascular lesions pose one of the major surgical risks in any operative procedure. While damage to minor and micro nerves cannot be avoided by the surgeon, large neurological structures by exact knowledge of their anatomical position and their potential variations can be protected. Planning of the surgical approach in accordance to the anatomic landmarks may help the surgeon in avoiding a large variety of foreseeable risks. However nerve lesions do occur and even the most diligent operating skills will never be able to rule out 100 % of the risk. Nerve lesions can be evaluated electrophysiologically or clinically. Most nerve lesions after humeral neck fracture have proven to be temporary with a high chance of full recovery [1]. Early detection as well as appropriate countermeasures have proven to have the most significant influence on the long term outcome. It is important to realize that, in both conservative and operative treatment of proximal humeral fractures, a paresis due to nerve injury can affect the restoration of shoulder motions [2].