Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review.

@article{Shao2005RadialNP,
  title={Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review.},
  author={Yi-Ching Shao and Paul J Harwood and Martin R W Grotz and David Limb and Peter V. Giannoudis},
  journal={The Journal of bone and joint surgery. British volume},
  year={2005},
  volume={87 12},
  pages={
          1647-52
        }
}
The management of radial nerve palsy associated with fractures of the shaft of the humerus has been disputed for several decades. This study has systematically reviewed the published evidence and developed an algorithm to guide management. We searched web-based databases for studies published in the past 40 years and identified further pages through manual searches of the bibliography in papers identified electronically. Of 391 papers identified initially, encompassing a total of 1045 patients… 
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394 Citations
Highly Influential Citations
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Background Citations
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Methods Citations
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Results Citations
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394 Citations

Review of Literature of Radial Nerve Injuries Associated with Humeral Fractures—An Integrated Management Strategy

The conservative strategy was a good choice for patients with low-energy closed fractures of humerus with radial nerve injury and should be followed within the first 2 weeks.

Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

No beneficial effect of early exploration on the recovery of primary RNP could be demonstrated when comparing patients managed non-operatively with those explored early, and patients managed operatively for closed humeral shaft fractures have a higher risk of developing secondary RNP.

Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review

There was a high rate of spontaneous radial nerve palsy recovery (85%) with radial nerve exploration increasing rates of resolution, and while exploration demonstrates increased resolution, it is yet to be determined which fractures are indicated for nerve exploration.

[Radial nerve palsy associated with humeral shaft fractures - early exploration or expectant procedure? An analysis concerning current strategies of treatment].

There is no consensus concerning the treatment of radial nerve palsies after humeral shaft fractures in Germany and whether and when an exploration of the radial nerve is obligatory in primary radial palsy remains unclear and should be clarified by prospective randomised trials.

Approach to radial nerve palsy caused by humerus shaft fracture: is primary exploration necessary?

Predictors of radial nerve palsy recovery in humeral shaft fractures: A retrospective review of 17 patients.

Iatrogenic radial nerve palsy after operative management of humeral shaft fractures.

The timing and pattern of radial nerve recovery in this situation was similar to that seen in primary radial nerve palsy, and there appears to be no advantage to early exploration of the radial nerve.

Radial Palsy and Humerus Fractures

The radial nerve palsy seems to be the most common nerve lesion complicating fractures of the humeral shaft, with a frequence of 4–16 % according to the different series, and treatment options include expectant observation, early exploration, late exploration, or performing tendon transfers.

Study of Incidence and Treatment of Radial Nerve Palsy inFracture Shaft of Humerus

The outcome of radial nerve palsy was not found to be related to age group, sex, side, mechanism of injury, intra-operative condition of nerve, method of treatment of fracture and time of exploration of radialNA, and a conservative and expectant line of management is recommended.

Need for early exploration of radial nerve in humeral shaft fractures with radial nerve palsy

Early exploration of the radial nerve should be considered in patients with radial nerve palsy associated with proximal third humeral shaft fracture, regardless of the fracture patterns caused by the high-energy trauma.
...

References

SHOWING 1-10 OF 54 REFERENCES

Immediate radial nerve palsy complicating fracture of the shaft of the humerus: when is early exploration justified?

Treatment of fractures of the shaft of the humerus accompanied by paralysis of the radial nerve.

Radial nerve paralysis associated with fractures of the humerus. A review of 62 cases.

Conservative management is recommended in patients with radial nerve paralysis associated with fractures of the humerus, regardless of age of the patient, cause of injury, level of fracture, type of fractures, and whether paralysis is primary or secondary.

Radial nerve palsy associated with humeral shaft fracture: evaluation with US--initial experience.

US may be useful for accurate evaluation of the radial nerve in patients with nerve palsy associated with humeral shaft fracture and findings of a severely damaged radial nerve were confirmed at surgical nerve inspection.

Radial nerve palsy after simple fracture of the humerus.

  • L. B. LarsenT. Barfred
  • Medicine
    Scandinavian journal of plastic and reconstructive surgery and hand surgery
  • 2000
A retrospective study on patients with radial nerve palsy after simple fracture of the humerus to assess the degree of spontaneous recovery and the need for exploration and repair of the nerve.

Radial nerve palsy associated with high-energy humeral shaft fractures.

[Indications, dangers and results of surgical treatment of humeral shaft fractures].

A series of 78 fractures of the humeral shaft is presented that were treated operatively between 1978 and 1987. Open fractures, fractures with primary palsy of the radial nerve, distal fractures with…

Radial nerve lesions associated with fractures of the humeral shaft.

Radial palsy in shaft fracture of the humerus.

No useful recovery of motor function could be seen in 13/59 patients with immediate palsy and in 2/16 patients with secondary palsy complicating a fracture of the shaft of the humerus.

Surgical Treatment of the Radial Nerve Lesions Associated with Fractures of the Humerus

Twelve patients who were surgically treated for radial nerve injuries associated with fractures of the humerus are reviewed, with excellent and good results obtained in 91% of cases.
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