nach oben

MUSCULOSKELETAL SURGERY

Erschienen in:

01.12.2016 | Review

Humerus shaft fracture complicated by radial nerve palsy: Is surgical exploration necessary?

verfasst von: M. Rocchi, L. Tarallo, R. Mugnai, R. Adani

Erschienen in: MUSCULOSKELETAL SURGERY | Sonderheft 1/2016

Einloggen, um Zugang zu erhalten

Abstract

Fractures of the humerus shaft often are complicated by radial nerve palsy. Controversy still exists in the treatment that includes clinical observation and eventually late surgical exploration or early surgical exploration. Algorithms have been proposed to provide recommendations with regard to management of the injuries. However, advantages and disadvantages are associated with each of these algorithms. The aim of this study was to analyze the indications of each treatment options and facilitate the surgeon in choosing the conduct for each lesion, proposing our own algorithm.

Holstein A, Lewis GM (1963) Fractures of the humerus with radial nerve paralysis. J Bone Joint Surg 45:1382–1388CrossRefPubMed

Shao YC, Harwood P, Grotz MRW, Limb D, Giannoudis PV (2005) Radial nerve palsy associated with fractures of the shaft of the humerus. A systematic review. J Bone Joint Surg Br Vol 87:1647–1652CrossRef

Carlan D, Pratt J, Patterson JMM, Weiland AJ, Boyer MI, Gelberman RH (2007) The radial nerve in the brachium: an anatomic study in human cadavers from the Department of Orthopaedic Surgery, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO; and the Hospital for Special Surgery, New York, NY

Bono C, Grossman M, Hochwald N, Tornetta P (2000) Radial and axillary nerves, anatomic considerations for humeral fixation. Clin Orthop Relat Res 373:259–264CrossRef

Pollock FH, Drake D, Bovill EG, Day L, Trafton PG (1981) Treatment of radial neuropathy associated with fractures of the humerus. J Bone Joint Surg 63:239–243CrossRefPubMed

Bostman O, Bakalim G, Vainionpaa S, Wilppula E, Patiala H, Rokkanen P (1986) Radial palsy in shaft fracture of the humerus. Acta Orthop Scand 57:316–319CrossRefPubMed

Garcia A, Maeck B (1960) Radial nerve injuries in fractures of the shaft of the humerus. Am J Surg 99:625–627CrossRefPubMed

Lowe JB 3rd, Sen SK, Mackinnon SE (2002) Current approach to radial nerve paralysis. Plast Reconstr Surg 110(4):1099–1113CrossRefPubMed

Amillo S, Barrios RH, Martinez-Peric R, Losada JI (1993) Surgical treatment of the radial nerve lesions associated with fractures of the humerus. J Orthop Trauma 7:211–215CrossRefPubMed

10.

Farragos A, Schemitsch E, McKee M (1999) Complications of intramedullary nailing for fractures of the humeral shaft: a review. J Orthop Trauma 13:258–267CrossRefPubMed

11.

Crolla K, de Varis L, Clevers G (1993) Locked intramedullary nailing of humeral shaft fractures. Injury 24:403–406CrossRefPubMed

12.

Bodner G, Huber B, Schwabegger A, Lutz M, Waldenberger P (1999) Sonographic detection of radial nerve entrapment within a humerus fracture. J Ultrasound Med 18(10):703–706PubMed

13.

Bodner G, Buchberger W, Schocke M et al (2001) Radial nerve palsy associated with humeral shaft fracture: evaluation with US: initial experience. Radiology 219(3):811–816CrossRefPubMed

14.

Filler AG, Maravilla KR, Tsuruda JS (2004) MR neurography and muscle MR imaging for image diagnosis of disorders affecting the peripheral nerves and musculature. Neurol Clin 22:643–682CrossRefPubMed

15.

Zhang H, Xiao B, Zou T (2006) Clinical application of magnetic resonance neurography in peripheral nerve disorders. Neurosci Bull 22:361–367PubMed

16.

Eppenberger P, Chhabra A, Andreisek G (2012) MR Neurography: imaging of the peripheral nervous system [German] Radiologie up 2date 12: 339–355

17.

Li YL, Ning GZ, Wu Q, Wu QL, Li Y, Feng SQ (2013) Review of literature of radial nerve injuries associated with humeral fractures: an integrated management strategy. Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, PR China. Plos One 8(11)

18.

Hanel DP (2006) Closed fractures complicated by peripheral nerve injury. J Am Acad Orthop Surg 14:32–37CrossRefPubMed

19.

Bishop J, Ring D (2009) Management of radial nerve palsy associated with humeral shaft fracture: a decision analysis model. J Hand Surg Am 34(6):991–996CrossRefPubMed

20.

Bumbasirević M, Lesić A, Bumbasirević V, Cobeljić G, Milosević I, Atkinson HD (2010) The management of humeral shaft fractures with associated radial nerve palsy: a review of 117 cases. Arch Orthop Trauma Surg 130:519–522CrossRefPubMed

21.

Larsen LB, Barfred T (2000) Radial nerve palsy after simple fracture of the humerus. Scand J Plast Reconstr Surg Hand Surg 34:363–366CrossRefPubMed

22.

Sonneveld GJ, Patka P, Van Mourik JC, Broere G (1989) Treatment of fractures of the shaft of the humerus accompanied by paralysis of radial nerve. Injury 18:404–406CrossRef

23.

Sunderland S (1978) When are attempts at nerve repair no longer justified? In: Sunderland S (ed) Nerves and nerve injuries. Churchill Livingstone, Edinburgh, pp 507–509

24.

Packer J, Foster R, Grantham S (1972) The humeral fracture with radial nerve palsy: is exploration warranted? Clin Orthop 88:34–38CrossRefPubMed

25.

DeFranco MJ, Lawton JN (2006) Radial nerve injuries associated with humeral fractures. J Hand Surg 31A:655–663CrossRef

26.

Elton SG, Rizzo M (2008) Management of radial nerve injury associated with humeral shaft fractures: an evidence-based approach. J Reconstr Microsurg 24(8):569–573CrossRefPubMed

27.

Mohler LR, Hanel DP (2006) Closed fractures complicated by peripheral nerve injury. J Am Acad Orthop Surg 14(1):32–37CrossRefPubMed

28.

Robinson LR (2000) Traumatic injury to peripheral nerves. Muscle Nerve 23(6):863–873CrossRefPubMed

29.

Robinson LR (2000) Role of neurophysiologic evaluation in diagnosis. J Am Acad Orthop Surg 8(3):190–199CrossRefPubMed

30.

Thomsen NOB, Dahlin LB (2007) Injury to the radial nerve caused by fracture of the humeral shaft: timing and neurobiological aspects related to treatment and diagnosis. Scand J Plast Reconstr Surg Hand Surg 41:153–157CrossRefPubMed

31.

Sunderland S (1951) A classification of peripheral nerve injuries producing loss of function. Brain 74:491–516CrossRefPubMed

32.

Seddon H (1947) Nerve lesions complicating certain close bone injuries. JAMA 135:691–694CrossRef

33.

Seddon H (1975) Surgical disorders of the peripheral nerves. Churchill Livingstone, Edinburgh

34.

Green DP, Hotchkiss RN, Pederson WC (eds) (1999) Green’s operative hand surgery. Churchill Livingston, Philadelphia

35.

Seddon HJ (1963) Nerve grafting. J Bone Joint Surg Br 45:447–461PubMed

36.

Niver GE, Ilyas AM (2013) Management of radial nerve palsy following fractures of the humerus

37.

Ljungquist KL, Martineau P, Allan C (2015) Radial nerve injuries. J Hand Surg Am 40(1):166–172CrossRefPubMed

38.

Gelberman RH (1991) Operative nerve repair and re- construction, vol. 2. Lippincott, Philadelphia, p xxix, 1625, 37

39.

Fu SY, Gordon T (1995) Contributing factors to poor functional recovery after delayed nerve repair: prolonged denervation. J Neurosci 15:3886–3895PubMed

40.

Fu SY, Gordon T (1995) Contributing factors to poor functional recovery after delayed nerve repair: prolonged axotomy. J Neurosci 15:3876–3885PubMed

41.

Korompilias AV, Lykissas MG, Kostas-Agnantis IP, Vekris MD, Soucacos PN, Beris AE (2013) Approach to radial nerve palsy caused by humerus shaft fracture: is primary exploration necessary? Injury 44:323–326CrossRefPubMed

42.

Dabezies E, Banta C, d’Ambrosia R (1992) Plate fixation of the humeral shaft for acute fractures, with and without radial nerve injuries. J Orthop Trauma 6:10–13PubMed

43.

Sarmiento A, Horowitch A, Vangsness C (1990) Functional bracing for comminuted extra-articular fractures of the distal third of the humerus. J Bone Joint Surg 72B:283–287

44.

Ingman A, Waters D (1994) Locked intramedullary nailing of the of humeral shaft fractures. J Bone Joint Surg 76B:23–29

45.

Rommens P, Verbruggen J, Broos P (1995) Retrograde locked nailing of the of humeral shaft fractures. J Bone Joint Surg 75B:84–89

46.

Chapman J, Hanley M, Benca P (2000) Randomized prospective study of humeral shaft fracture fixation: intramedullary nails versus plates. J Orthop Trauma 14:162–166CrossRefPubMed

47.

McCormack R, Brien D, Schemitsch E (2000) Fixation of fractures of the shaft of the humerus by dynamic compression pate or intramedullary nail: a prospective randomized trial. J Bone Joint Surg 82B:336–339CrossRef

48.

Modabber M, Jupiter J (1998) Operative management of diaphyseal fractures of the humerus. Clin Orthop 347:93–104CrossRef

49.

Packer J, Foster R, Grantham S (1972) The humeral fracture with radial nerve palsy: is exploration warranted? Clin Orthop 88:34–38CrossRefPubMed

50.

Shaw J, Sakellarides H (1967) Radial-nerve paralysis associated with fractures of the humerus: a review of forty-five cases. J Bone Joint Surg 49A:899–902CrossRef

51.

Shergill G, Bonney G, Munshi P, Birch R (2001) The radial and posterior interosseous nerves. Results for 260 repairs. J Bone Joint Surg Br 83:646–649CrossRefPubMed

52.

Kalomiri DE, Soucacos PN, Beris AE (1994) Nerve grafting in peripheral nerve micro-surgery of the upper extremity. Microsurgery 15:506–511CrossRefPubMed

53.

Nunley JA, Saies AD, Sandow MJ, Urbaniak JR (1996) Results of interfascicular nerve grafting for radial nerve lesions. Microsurgery 17:431–437CrossRefPubMed

54.

Bushart T (1999) Green’s operative hand surgery, 4th edn. Churchill Livingstone, Philadelphia, pp 1381–1404

55.

Kruft S, von Heimburg D, Reill P (1997) Treatment of irreversible lesion of the radial nerve by tendon transfer: indication and long-term results of the Merle d’Aubigne procedure. Plastic Reconstr Surg 100:610–618CrossRef

Titel: Humerus shaft fracture complicated by radial nerve palsy: Is surgical exploration necessary?
verfasst von: M. Rocchi
L. Tarallo
R. Mugnai
R. Adani
Publikationsdatum: 01.12.2016
Verlag: Springer Milan
Erschienen in: MUSCULOSKELETAL SURGERY / Ausgabe Sonderheft 1/2016
Print ISSN: 2035-5106
Elektronische ISSN: 2035-5114
DOI: https://doi.org/10.1007/s12306-016-0414-3

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Sonderheft 1/2016

Sleep quality and disturbances in patients with different-sized rotator cuff tear

Customized tantalum-augmented reverse shoulder arthroplasty for glenoid bone defect and excessive medialization: description of the technique

Distal-third diaphyseal fractures of the humerus: choice of approach and surgical treatment

Fluoroscopy-guided biodegradable spacer implantation using local anesthesia: safety and efficacy study in patients with massive rotator cuff tears

Double-locking precontoured plating system for malunited fractures of the distal end of humerus