Radial nerve recovery following closed nailing of humeral shaft fractures without radial nerve exploration: A retrospective study

World J Clin Cases. 2021 Sep 26;9(27):8044-8050. doi: 10.12998/wjcc.v9.i27.8044.

Abstract

Background: Radial nerve palsy due to humeral shaft fracture is the most common peripheral nerve injury associated with long bone fractures. An antegrade nailing surgical technique is becoming popular for the fixation of these fractures with minimal invasiveness. We analyzed nerve recovery in patients with humeral shaft fracture and radial nerve palsy treated with humeral nail fixation without nerve exploration.

Aim: To assess the radial nerve recovery rate and time from humeral shaft fracture with surgical treatment using close nailing.

Methods: We retrospectively collected data of patients who underwent undergone surgical nail fixation for humeral shaft fractures between October 1, 2016, and March 31, 2020. Subsequently, we analyzed the primary or secondary radial nerve palsy recovery rate and radial nerve motor function recovery time.

Results: The study included 70 patients who underwent surgical treatment for closed- or Gustilo type I open humeral shaft fractures using a nail fixation technique without radial nerve exploration. The patients suffered from primary (n = 5) and secondary (n = 5) radial nerve palsy. A 100% radial nerve recovery rate was achieved. The mean recovery time was 4.3 mo.

Conclusion: The study results indicate full recovery of radial nerve palsies from humeral shaft fracture using close nailing treatment. Surgeons need not be concerned about the occurrence of permanent nerve palsies.

Keywords: Close nailing fixation; Humeral shaft fracture; Nerve exploration; Radial nerve palsy.