Abstract
PurposeThe purpose of this study was to assess recovery and clinical outcome in patients with primary or secondary radial nerve palsy following humeral shaft fracture.MethodsWe retrospectively assessed 102 patients (45 female and 57 male) with humeral shaft fracture and concomitant radial nerve palsy, who were followed up for 12 months. Patients were divided into two groups with primary or secondary radial nerve palsy depending on the onset. Muscle function was measured according to Daniels classification and degree of nerve damage was assessed by the Sunderland classification.ResultsThe average time for onset of recovery after primary RNP was 10.5 ± 3.31 weeks, in the case of secondary RNP it was 8.9 ± 7.98 weeks (p < 0.05). Full recovery or significant improvement was achieved with average of 26.7 ± 8.86 weeks and 23.9 ± 6.04 weeks respectively (p < 0.05). Trauma mechanism and type of treatment had no significant influence on time of onset of recovery or time to full recovery (p < 0.904).ConclusionSecondary RNP shows tendency for earlier recovery and is more commonly associated with ORIF.
Highlights
Humeral shaft fractures are often associated with radial nerve palsy, which represents the most common traumatic nerve injury [1,2,3]
A total of 53 patients (52 %) sustained a high energy trauma and 49 (48 %) patients sustained a low energy trauma leading to a humeral shaft fracture
High energy trauma was more frequently seen in male patients (68.4 %) (p < 0.05) whereas low energy trauma was more common in female patients (68.8 %) (p < 0.05)
Summary
Humeral shaft fractures are often associated with radial nerve palsy, which represents the most common traumatic nerve injury [1,2,3]. The overall incidence of radial nerve palsy following humeral shaft fractures is about 2–18 %, in mean 12 % [4, 5]. Due to different methods of fixation for humeral shaft fractures regarding closed or open fracture reduction, it is necessary to decide if early exploration in primary radial nerve palsy is indicated [4, 6]. Open or closed reduction of humeral shaft fractures is accompanied by resulting secondary radial nerve palsy in 6–12 % [8]. Due to a high rate of spontaneous recovery, conservative treatment of radial nerve palsy and non operative fracture fixation have been postulated [6]
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