Abstract
Radial nerve palsies in closed humeral shaft fractures are common, with an incidence of 7%-17%. The management of radial nerve palsies in closed fractures is often expectant, with 70.7% spontaneously recovering within six months. A literature search was conducted for studies on radial nerve palsies in humeral shaft fractures from 2000-2018. A total of 4972 humeral shaft fractures were identified, with an incidence of 12.2% of primary radial nerve palsies. During the exploration, no neurological intervention was performed in nearly 41% of cases, and the most common finding was no evidence of any nerve lesion (35%). Those who underwent neurolysis were more likely to resolve when compared to primary repair or nerve grafting. Overall, there was a high rate of spontaneous radial nerve palsy recovery (85%) with radial nerve exploration increasing rates of resolution. While exploration demonstrates increased resolution, it is yet to be determined which fractures are indicated for nerve exploration.
Highlights
BackgroundThe most recent systematic reviews performed on the incidence of and factors associated with radial nerve palsies in humeral shaft fractures were performed in 2013 and 2019 [1,2]
This review identified 607 primary radial nerve palsies in 4,972 fractures giving an incidence of 12.2%, which is similar to a previous review by Shao in 2005 (11.8%) and a new 2019 review by Mangan et al (12.3%) [2,3]
The incidence of primary radial nerve palsy in this population of 4,972 humeral shaft fractures was 12.2%, which is consistent with previous studies
Summary
The most recent systematic reviews performed on the incidence of and factors associated with radial nerve palsies in humeral shaft fractures were performed in 2013 and 2019 [1,2]. Mangan et al concluded that the overall prevalence of radial nerve palsy was 12.3% in a population of 7,262 fractures [2]. In 2013, Li et al determined the incidence of radial nerve palsies in these injuries to be 16.3% in a population of 1882 humeral shaft fractures [1]. The high incidence of radial nerve palsy in humeral shaft fractures makes this the most common peripheral nerve injury in long bone fractures [5]
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