Abstract
Background:Today, humerus nails have become the surgical method of choice in the treatment of humerus shaft fractures. Whether or not the radial nerve should be intraoperatively examined by default in case of primary paresis is currently under discussion.Patients and Methods:Clinical findings from 38 patients with humeral shaft fractures surgically treated with unreamed humerus nail (UHN) at the Department of Accident Surgery, University Clinics Bonn, Germany, between 2000 and 2003 were retrospectively assessed. Constant Score was applied for evaluation of functional results.Results:In 40% of patients, primary radial nerve paresis was present. This was especially common after high energy trauma (e.g. traffic accident) and significantly increased in fractures of the middle third. In 93% of cases, spontaneous remission of motor and sensory loss was observed. No iatrogenic radial nerve impairment occurred.Conclusion:Due to the high rates of spontaneous remissions of radial nerve palsy after treatment with UHN in humerus shaft fractures, primar exploration of the radial nerve does not appear to be necessary.
Highlights
In accident surgery, humerus shaft fracture is not very common, with an incidence of 1% in relation to fractures of all limbs
Shao and coworkers reported on 532 cases of radial nerve palsy in 4517 humerus shaft fractures [1] corresponding to a rate of 11.8%
Between 24 Nov 2000 and 7 March 2003, 38 patients (20 female (53%) and 18 male (47%)) with humeral shaft fractures were treated with unreamed humerus nails (UHN) at the Department of Accident Surgery, University Clinics Bonn, Germany
Summary
Humerus shaft fracture is not very common, with an incidence of 1% in relation to fractures of all limbs. Shao and coworkers reported on 532 cases of radial nerve palsy in 4517 humerus shaft fractures [1] corresponding to a rate of 11.8%. In the last 50 years, therapy of humerus shaft fracture has been widely discussed. A distinct trend towards surgical treatment has been noted since the 1980s. While in 1964, Böhler still postulated conservative treatment of this fracture [2], by 1991, more than 50% of humerus fractures were treated surgically [3], mostly with osteosynthetic plating with mandatory examination of the radial nerve. Humerus nails have become the surgical method of choice in the treatment of humerus shaft fractures. Whether or not the radial nerve should be intraoperatively examined by default in case of primary paresis is currently under discussion
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