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Final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion

BACKGROUND: Little evidence regarding the extent of recovery of radial nerve lesions with associated humerus trauma exists. The aim of this study is to examine the incidence and resolution of types of radial nerve palsy (RNP) in operative and nonoperative humeral shaft fracture populations. MATERIAL...

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Autores principales: Belayneh, Rebekah, Lott, Ariana, Haglin, Jack, Konda, Sanjit, Leucht, Philipp, Egol, Kenneth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439110/
https://www.ncbi.nlm.nih.gov/pubmed/30923949
http://dx.doi.org/10.1186/s10195-019-0526-2
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author Belayneh, Rebekah
Lott, Ariana
Haglin, Jack
Konda, Sanjit
Leucht, Philipp
Egol, Kenneth
author_facet Belayneh, Rebekah
Lott, Ariana
Haglin, Jack
Konda, Sanjit
Leucht, Philipp
Egol, Kenneth
author_sort Belayneh, Rebekah
collection PubMed
description BACKGROUND: Little evidence regarding the extent of recovery of radial nerve lesions with associated humerus trauma exists. The aim of this study is to examine the incidence and resolution of types of radial nerve palsy (RNP) in operative and nonoperative humeral shaft fracture populations. MATERIALS AND METHODS: Radial nerve lesions were identified as complete (RNPc), which included motor and sensory loss, and incomplete (RNPi), which included sensory-only lesions. Charts were reviewed for treatment type, radial nerve status, RNP resolution time, and follow-up time. Descriptive statistics were used to document incidence of RNP and time to resolution. Independent-samples t-test was used to determine significant differences between RNP resolution time in operative and nonoperative cohorts. RESULTS: A total of 175 patients (77 operative, 98 nonoperative) with diaphyseal humeral shaft injury between 2007 and 2016 were identified and treated. Seventeen out of 77 (22.1%) patients treated operatively were diagnosed preoperatively with a radial nerve lesion. Two (2.6%) patients developed secondary RNPc postoperatively. Eight out of 98 (8.2%) patients presented with RNP postinjury for nonoperatively treated humeral shaft fracture. All patients who presented with either RNPc, RNPi, or iatrogenic RNP had complete resolution of their RNP. No statistically significant difference was found in recovery time when comparing the operative versus nonoperative RNPc, operative versus nonoperative RNPi, or RNPc versus RNPi patient groups. CONCLUSIONS: All 27 (100%) patients presenting with or developing radial nerve palsy in our study recovered. No patient required further surgery for radial nerve palsy. Radial nerve exploration in conjunction with open reduction and internal fixation (ORIF) appears to facilitate speedier resolution of RNP when directly compared with observation in nonoperative cases, although not statistically significantly so. These findings provide surgeons valuable information they can share with patients who sustain radial nerve injury with associated humerus shaft fracture or nonunion. LEVEL OF EVIDENCE: Level III treatment study.
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spelling pubmed-64391102019-04-15 Final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion Belayneh, Rebekah Lott, Ariana Haglin, Jack Konda, Sanjit Leucht, Philipp Egol, Kenneth J Orthop Traumatol Original Article BACKGROUND: Little evidence regarding the extent of recovery of radial nerve lesions with associated humerus trauma exists. The aim of this study is to examine the incidence and resolution of types of radial nerve palsy (RNP) in operative and nonoperative humeral shaft fracture populations. MATERIALS AND METHODS: Radial nerve lesions were identified as complete (RNPc), which included motor and sensory loss, and incomplete (RNPi), which included sensory-only lesions. Charts were reviewed for treatment type, radial nerve status, RNP resolution time, and follow-up time. Descriptive statistics were used to document incidence of RNP and time to resolution. Independent-samples t-test was used to determine significant differences between RNP resolution time in operative and nonoperative cohorts. RESULTS: A total of 175 patients (77 operative, 98 nonoperative) with diaphyseal humeral shaft injury between 2007 and 2016 were identified and treated. Seventeen out of 77 (22.1%) patients treated operatively were diagnosed preoperatively with a radial nerve lesion. Two (2.6%) patients developed secondary RNPc postoperatively. Eight out of 98 (8.2%) patients presented with RNP postinjury for nonoperatively treated humeral shaft fracture. All patients who presented with either RNPc, RNPi, or iatrogenic RNP had complete resolution of their RNP. No statistically significant difference was found in recovery time when comparing the operative versus nonoperative RNPc, operative versus nonoperative RNPi, or RNPc versus RNPi patient groups. CONCLUSIONS: All 27 (100%) patients presenting with or developing radial nerve palsy in our study recovered. No patient required further surgery for radial nerve palsy. Radial nerve exploration in conjunction with open reduction and internal fixation (ORIF) appears to facilitate speedier resolution of RNP when directly compared with observation in nonoperative cases, although not statistically significantly so. These findings provide surgeons valuable information they can share with patients who sustain radial nerve injury with associated humerus shaft fracture or nonunion. LEVEL OF EVIDENCE: Level III treatment study. Springer International Publishing 2019-03-28 2019-12 /pmc/articles/PMC6439110/ /pubmed/30923949 http://dx.doi.org/10.1186/s10195-019-0526-2 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Belayneh, Rebekah
Lott, Ariana
Haglin, Jack
Konda, Sanjit
Leucht, Philipp
Egol, Kenneth
Final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion
title Final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion
title_full Final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion
title_fullStr Final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion
title_full_unstemmed Final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion
title_short Final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion
title_sort final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439110/
https://www.ncbi.nlm.nih.gov/pubmed/30923949
http://dx.doi.org/10.1186/s10195-019-0526-2
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