Causes of Secondary Radial Nerve Palsy and Results of Treatment

Overview

Journal Med Sci Monit

Specialties General Medicine
Pathology

Date 2016 Feb 20

PMID 26895570

Citations 13

Authors

Pawel Reichert

Witold Wnukiewicz

Jaroslaw Witkowski

Aneta Bochenska

Sylwia Mizia

Jerzy Gosk

Krzysztof Zimmer

Affiliations

Soon will be listed here.

Abstract

BACKGROUND The aim of this study was to analyze the causes that lead to secondary damage of the radial nerve and to discuss the results of reconstructive treatment. MATERIAL AND METHODS The study group consisted of 33 patients treated for radial nerve palsy after humeral fractures. Patients were diagnosed based on clinical examinations, ultrasonography, electromyography, or nerve conduction velocity. During each operation, the location and type of nerve damage were analyzed. During the reconstructive treatment, neurolysis, direct neurorrhaphy, or reconstruction with a sural nerve graft was used. The outcomes were evaluated using the Medical Research Council (MRC) scales and the quick DASH score. RESULTS Secondary radial nerve palsy occurs after open reduction and internal fixation (ORIF) by plate, as well as by closed reduction and internal fixation (CRIF) by nail. In the case of ORIF, it most often occurs when the lateral approach is used, as in the case of CRIF with an insertion interlocking screws. The results of the surgical treatment were statistically significant and depended on the time between nerve injury and revision (reconstruction) surgery, type of damage to the radial nerve, surgery treatment, and type of fixation. Treatment results were not statistically significant, depending on the type of fracture or location of the nerve injury. CONCLUSIONS The potential risk of radial nerve neurotmesis justifies an operative intervention to treat neurological complications after a humeral fracture. Adequate surgical treatment in many of these cases allows for functional recovery of the radial nerve.

Citing Articles

Anterograde Intramedullary Nailing without Bone Grafting for Humeral Shaft Nonunion Associated with Early Exploration of Secondary Radial Nerve Palsy: A Case Report.

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Distal locking technique affects the rate of iatrogenic radial nerve palsy in intramedullary nailing of humeral shaft fractures.

Greiner F, Kaiser G, Kleiner A, Brugger J, Aldrian S, Windhager R Arch Orthop Trauma Surg. 2022; 143(7):4117-4123.

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Etiological and epidemiological characteristics of surgically treated radial nerve lesions: A 20-year single-center experience.

Rasulic L, djuraskovic S, Lakicevic N, Lepic M, Savic A, Grujic J Front Surg. 2022; 9:942755.

PMID: 36204344 PMC: 9530258. DOI: 10.3389/fsurg.2022.942755.

Ultrasound-guided preoperative localization of radial nerve in the treatment of extra-articular distal humeral shaft fractures.

Li W, Li H, Wang H, Wang S BMC Musculoskelet Disord. 2022; 23(1):1.

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Measurement of the Radial Nerve Danger Zone in Filipino Adults: A Cadaveric Study.

Rubio D, Pacheco A, Abrilla A Malays Orthop J. 2021; 15(3):45-51.

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