Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Aug;39(8):1653-7.
doi: 10.1007/s00264-015-2745-3. Epub 2015 Mar 28.

Plate osteosynthesis of humeral diaphyseal fractures associated with radial palsy: twenty cases

Regis Pailhé  1 , Virginie Mesquida, Brice Rubens-Duval, Dominique Saragaglia
Affiliations

Plate osteosynthesis of humeral diaphyseal fractures associated with radial palsy: twenty cases

Regis Pailhé et al. Int Orthop. 2015 Aug.

Abstract

Background: Surgical management of humeral fractures associated with radial nerve palsy remains controversial. Some advocate surgical treatment in emergency while others recommend nonoperative treatment.

Purpose: The aim of the study was to assess nerve recovery in a series of patients treated with open reduction and internal fixation (ORIF) with plate for humeral fracture associated with radial nerve palsy. We hypothesised that surgical treatment with ORIF in emergency allows good nerve recovery.

Methods: We conducted a retrospective study on 20 patients out of 225 humeral shaft fractures operated between 1995 and 2012. There were 11 women and nine men, with a mean age of 51 ± 22 years (23-93). The fractures were located in mid third of the shaft in 15 cases (75 %), distal third in four (20 %) and superior third in one (5 %). Mean delay for surgical treatment was three days (zero to 15). The plate was positioned at the medial face in 16 cases (80 %) and posterior face in four (20 %). In six cases, the radial nerve was not seen (30 %). In the 14 cases where it was seen (70 %), it was continuous. Neurolysis was performed in seven cases (35 %).

Results: Fifteen patients (75 %) had a good nerve palsy recovery, with a mean delay of ten months (six to 12). Statistically significant correlation was observed between delay of surgical treatment and delay of radial recovery (p = 0.0166 ; Rho = - 0.53). Early osteosynthesis was correlated with better nerve recovery. One patient required complementary nerve surgery and another tendon transfer. Bone healing was obtained in all cases. Concerning functional outcomes, mean QuickDASH, a shortened version of the Disabilities of the Arm, Shoulder and Hand (DASH) score, was 9 ± 17 (0-59), and 85 % of patients were able to recover their previous physical activities.

Conclusion: ORIF by plate of humeral shaft fracture with radial nerve palsy in emergency allows good palsy recovery (75 %) with a short delay (about three days).

Level of evidence: Level IV, retrospective study.

PubMed Disclaimer

Comment in

References

    1. J Hand Surg Am. 2008 Oct;33(8):1433-4 - PubMed
    1. Rev Chir Orthop Reparatrice Appar Mot. 2002 Nov;88(7):655-62 - PubMed
    1. J Hand Surg Am. 2011 May;36(5):905-6 - PubMed
    1. J Hand Surg Eur Vol. 2007 Oct;32(5):529-33 - PubMed
    1. Orthop Traumatol Surg Res. 2013 Oct;99(6):707-12 - PubMed

LinkOut - more resources