scholarly journals Iatrogenic Radial Nerve Palsy following Closed Reduction of a Simple Diaphyseal Humeral Fracture: Beware the Perfect X-Ray

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Morgan Jones ◽  
Hean Wu Kang ◽  
Christopher O’Neill ◽  
Paul Maginn
Keyword(s):  
Nerve Injury ◽  
Clinical Assessment ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Humeral Fracture ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Radial Nerve Palsy ◽  
X Ray ◽  
Radial Nerve Injury

Radial nerve injury is a recognised complication associated with humeral shaft fracture. A case of iatrogenic radial nerve injury is presented following fracture reduction. The relevant anatomy, challenges in management of humeral fractures with associated radial nerve injury, and the importance of detailed clinical assessment and documentation are discussed.

THE RADIAL NERVE PALSY CAUSED BY EMBEDDING IN THE HUMERAL SHAFT FRACTURE — A CASE REPORT

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 91-93 ◽  
Author(s):  
Kazuo Ikeda ◽  
Naoki Osamura
Keyword(s):  
Radial Nerve ◽  
Traffic Accident ◽  
Nerve Palsy ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Fracture Callus ◽  
X Ray ◽  
One Year

This paper examines a case of radial nerve palsy in a 13-year-old girl caused by nerve embedded in a humeral shaft fracture. An X-ray showed a mild angular-displaced humeral shaft fracture. Two weeks later, an intramedullary Ender nailing was performed. Because of brain injury due to traffic accident, the patient lost consciousness for one month. Once she regained consciousness, radial nerve palsy was discovered and closely observed. As the radial nerve palsy had not healed after five months, the radial nerve was explored and found to be interposed between fracture sites and totally entrapped in the fracture callus. During surgery, both the proximal and distal ends of the radial nerve were cut at the surface of the humeral bone. Then, the radial nerve stumps were end-to-end sutured because of their enough length. One year after surgery, the radial nerve palsy had completely recoverd.

scholarly journals Managing Radial Nerve Injuries Associated with Humeral Fracture

2020 ◽  
Vol 71 (1) ◽  
pp. 400-404
Author(s):  
Vlad Carbunaru ◽  
Ana Maria Oproiu ◽  
Adrian Barbilian ◽  
Chen Feng-Ifrim ◽  
Alexandra Ciotei
Keyword(s):  
Nerve Injury ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Bone Fractures ◽  
Humeral Fracture ◽  
High Energy ◽  
Humeral Shaft ◽  
Long Bone ◽  
Radial Nerve Palsy ◽  
Radial Nerve Injury

The overall prevalence of radial nerve injury after humeral shaft fractures is up to 18% representing the most common peripheral nerve injury associated with long bone fractures. Spiral or oblique fractures of the junction between the middle and distal third of the humeral shaft are at greater risk for radial nerve injury. Iatrogenic damage to the radial nerve may also occur during manipulations of closed reduction. A prospective study between 2017-2019 following 5 patients (all male, with ages between 30 and 56 years old), who were treated at our clinic for complete radial nerve palsy after a high-energy fracture of the humerus. All the patients were followed-up for a mean of 6 months (range 4 - 15 months) post op. The first 3 cases showed the initial signs of recovery 4 weeks after the operation. In the last 2 cases a palliative radial intervention was required. The consequences of the radial nerve palsy associated with humeral fractures is strongly related to trauma mechanism. In high energy fractures, severe contusion or transection of the nerve must be expected. In this case, nerve recovery is unlikely and the patients should be informed of the poor prognosis and the need of tendon transfers.

Humeral shaft fracture and radial nerve palsy in Korean soldiers: focus on arm wrestling related injury

2020 ◽  
pp. jramc-2019-001373
Author(s):  
Kyoung-Eun Kim ◽  
E-J Kim ◽  
J Park ◽  
SW Kim ◽  
J Kwon ◽  
...  
Keyword(s):  
External Force ◽  
Military Service ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Humeral Fracture ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Humeral Shaft Fractures

IntroductionHumeral shaft fractures can lead to radial nerve injury and may require surgery and rehabilitation. We determined the causative events of humeral fracture, including arm wrestling, in young Korean soldiers and examined whether humeral fracture is related to demographic characteristics and the presence of radial nerve palsy.MethodsWe reviewed 7.5 years (July 2012 to June 2019) of medical records covering patients who had experienced a humeral shaft fracture after entering military service and had received surgery for open reduction and internal fixation. Data were obtained on basic demographics, initial event provoking the fracture, presence of radial nerve palsy, initial and follow-up severity of the weakness, and any discharge from military service because of prolonged radial nerve palsy.ResultsOf 123 cases, arm wrestling was the leading cause (52.8%). A high energy injury, such as falling from a height (11.4%), and sports related slips (10.6%) were other causes. All humeral shaft fractures caused by forceful contraction were spiral, while 40% of the fractures caused by external force related events were of a transverse type. The percentage of left-sided fractures was significantly higher for fractures arising from an external force than in those caused by forceful contraction related events. Radial nerve palsy was found in 34 patients (27.6%), and 16 were discharged from the military because of prolonged radial nerve palsy 6 months after the fracture. The causative events and other factors did not affect the presence of radial nerve palsy.ConclusionArm wrestling was the leading cause of humeral fracture in young Korean soldiers but the chance of developing comorbid radial nerve palsy did not differ from that of other causes. These epidemiologic findings in this young active group may help in understanding the causes of humeral shaft fracture in soldiers and in the wider young population.

scholarly journals Humeral shaft fracture associated with radial nerve palsy -a case report

2021 ◽  
pp. 54-55
Author(s):  
Rishitha M ◽  
Akasha Sindhu M
Keyword(s):  
Radial Nerve ◽  
Nerve Palsy ◽  
Wrist Joint ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Loss Of Function ◽  
History Of ◽  
The Right

Radial nerve palsy was induced by radial nerve compression, which was often caused by humerus bone fracture. This leads to pain, weakness, or loss of function mostly in the wrist, hand, and fingers. We reported a case of a 24-year-old male patient with complaints of swelling of the right-hand wrist joint and pain during extension and flexion while moving. He had a three-month history of mild displaced humeral shaft fracture from a traffic accident and an intramedullary Ender nailing was performed. He now has been admitted with swelling in his right wrist joint and pain while moving his hand. The case was diagnosed as Radial nerve palsy. Surgery was performed, the proximal and distal ends of the radial nerve were separated at the humeral bone's surface. The radial nerve stumps were enough long to be sutured. Our one-month follow-up shows no complications. The majority cases of radial nerve palsy will resolve within a few weeks after surgery, as our patient did, and the most prominent is patient education.

Radial Nerve Palsy Associated with Humeral Shaft Fracture: Evaluation with US—Initial Experience

Radiology ◽  
2001 ◽  
Vol 219 (3) ◽  
pp. 811-816 ◽  
Author(s):  
Gerd Bodner ◽  
Wolfgang Buchberger ◽  
Michael Schocke ◽  
Reto Bale ◽  
Burkart Huber ◽  
...  
Keyword(s):  
Radial Nerve ◽  
Nerve Palsy ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Initial Experience

scholarly journals Secondary Radial Nerve Palsy after Minimally Invasive Plate Osteosynthesis of a Distal Humeral Shaft Fracture

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Ursina Bichsel ◽  
Richard Walter Nyffeler
Keyword(s):  
Minimally Invasive ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Plate Osteosynthesis ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Short Time

Minimally invasive plate osteosynthesis is a widely used procedure for the treatment of fractures of the femur and the tibia. For a short time it is also used for the treatment of humeral shaft fractures. Among other advantages, the ambassadors of this technique emphasize the lower risk of nerve injuries when compared to open reduction and internal fixation. We report the case of secondary radial nerve palsy caused by percutaneous fixation of a plate above the antecubital fold. The nerve did not recover and the patient needed a tendon transfer to regain active extension of the fingers. This case points to the importance of adequate exposure of the bone and plate if a humeral shaft fracture extends far distally.

scholarly journals Treatment of Radial Nerve Palsy Associated with Humeral Shaft Fracture

2020 ◽  
Vol 25 (1) ◽  
pp. 60-66
Author(s):  
Soo-Hong Han ◽  
Jin-Woo Cho ◽  
Han-Seung Ryu
Keyword(s):  
Radial Nerve ◽  
Poor Prognosis ◽  
Nerve Palsy ◽  
Shaft Fracture ◽  
Scar Tissue ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Surgical Exploration ◽  
Secondary Nerve

Radial nerve palsy associated with humeral shaft fracture is divided into primary paralysis immediately after injury and secondary paralysis after reduction or surgery. There are conflicting opinions about the timing and necessity of early neuro-exploration for patient with primary paralysis. The main cause of radial nerve injury is nerve contusion and it has high natural recovery rate without any treatment on nerves. However, if the nerve is damaged, early neuro-exploration is needed to increase the possibility of full recovery, prevent secondary nerve damage by the bone or scar tissue and predict prognosis. Through this, there is an advantage to plan future treatment. Based on the study of these patients, when internal fixation is indicated, early surgical exploration of the radial nerve should be considered to minimize poor prognosis and conflict with the patient.

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