FREQUENCY OF RADIAL NERVE INJURY IN PATIENTS WITH CLOSED FRACTURE OF HUMERUS SHAFT IN HIGH ENERGY TRAUMA CASES
DOI:
https://doi.org/10.55519/JAMC-04-S4-11082Keywords:
Closed fracture of the humerus, Humerus Shaft, Radial Nerve InjuryAbstract
Background: Fracture of the humerus usually result in radial nerve injury. This study was done with the aim to determine the incidence of Radial Nerve Injury in patients with closed fracture of the humerus shaft in high-energy trauma cases. Methods: This descriptive study was conducted in the Department of Orthopedics and Emergency room, Ghurki Teaching Hospital, Lahore from January to December 2021 recruiting consecutive such patients. Standard ward protocol was followed to manage the patients initially including fracture stabilization and analgesia requirement. All the patients were carefully assessed to detect radial nerve injury. Data analysis was done through SPSS 26.0. Results: A total of 80 patients were included with the confirmed diagnosis of fracture of the humerus. There were 55(68.5%) males and 25(31.25%) females. The age range was 20 to 60 years and the mean age of males and females was 31.62±8.35 and 38.43±5.06 respectively with overall mean age±SD was 38.93±6.19. There were 32 (40%) cases of spiral fracture, 17 (21.25%) cases of transverse fracture, 16 (20%) cases of communized fracture, and 15 (18.75%) cases of segmental fracture. Radial nerve injury was present in 7 (8.75%) patients. Out of these 7 cases of radial nerve injury; 4 (57.1%) cases were recorded in patients with spiral closed fracture of midshaft of humerus, 1 (14.3%) cases were recorded in transverse closed fracture of humerus shaft, 1(14.3%) cases in comminuted closed fracture of midshaft of the humerus while 1 (14.3%) were segmental fractures. Conclusion: Our study highlighted the frequency of radial nerve palsy in humeral shaft cases with most common in spiral closed fracture of the midshaft of the humerus.References
Suwannaphisit S, Aonsong W, Suwanno P, Chuaychoosakoon C. Location of the radial nerve along the humeral shaft between the prone and lateral decubitus positions at different elbow positions. Sci Rep 2021;11(1):17215.
Hendrickx LA, Hilgersom NF, Alkaduhimi H, Doornberg JN, van den Bekerom MP. Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients. Arch Orthop Trauma Surg 2021;141(4):561–8.
Patra A, Chaudhary P, Arora K, Ravi KS. Surgical anatomy of the radial nerve in the anterior compartment of the arm: relationship with the triceps aponeurosis. Surg Radiol Anat 2021;43(5):689–94.
Sapage R, Pereira PA, Vital L, Madeira MD, Pinho A. Surgical anatomy of the radial nerve in the arm: a cadaver study. Eur J Orthop Surg Traumatol 2021;31(7):1457–62.
Mazerolle M, Michaud J, Boudier-Revéret M. Radial Nerve Compression Secondary to Orthopedic Fixation Plate for Humeral Shaft Fracture: Iatrogenic Double Crush Syndrome. Am J Phys Med Rehabil 2021;100(7):e104–5.
Chang G, Ilyas AM. Radial nerve palsy after humeral shaft fractures: the case for early exploration and a new classification to guide treatment and prognosis. Hand Clin 2018;34(1):105–12.
Latef TJ, Bilal M, Vetter M, Iwanaga J, Oskouian RJ, Tubbs RS. Injury of the radial nerve in the arm: a review. Cureus 2018;10(2):e2199.
Niver GE, Ilyas AM. Management of radial nerve palsy following fractures of the humerus. Orthop Clin 2013;44(3):419–24.
Singh V, Hayes HV, Kazemi N, Dey S, Parikh SN. The Holstein-Lewis humerus shaft fracture in children: are they different from adults? J Pediatr Orthop B 2022;31(3):274–80.
Moloney DP, Feeley I, Hughes AJ, Merghani K, Sheehan E, Kennedy M. Injuries associated with arm wrestling: A narrative review. J Clin Orthop Trauma 2021;18:30–7.
Shah S, Desai A, Dalal B, Shah S, Trivedi S, Modi H. Study of functional and radiological outcome in humerus shaft fractures treated with anterior bridge plating. Int J Orthop 2021;7(4):243–8.
Ali F, Ahmed M, Kamran QU, Batool S, Ansari AJ, Tariq F, et al. Motorized Two-Wheeler Accidents; A leading Cause of Death and Disabilities: Autopsy Based Study in Tertiary Care Hospital. Ann Punjab Med Coll 2021;15(1):55–9.
Yeh KL, Liaw CK, Wu TY, Chen CP. Radial nerve recovery following closed nailing of humeral shaft fractures without radial nerve exploration: A retrospective study. World J Clin Cases 2021;9(27):8044–50.
Shao YC, Harwood P, Grotz MR, Limb D, Giannoudis PV. Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review. J Bone Joint Surg Br 2005;87(12):1647–52.
Shao Y. Systematic review of radial nerve palsy associated with humeral shaft fracture. Chin J Orthop. 1996;12:541938.
Khan MK, Khan MS. Frequency of Radial Nerve Injury in Patients with Closed Fracture of Humerus Shaft. Pattern Differ Age Groups 2014;12(1):83.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.