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Surgical Treatment of Radial Nerve Injuries Associated With Humeral Shaft Fracture—A Single Center Experience

Radial nerve injuries are often associated with humeral shaft fractures. The results of treatment of these injuries, by contemporary surgical approaches, remain diverse. In this paper we presented the outcomes and analyzed the patient, clinical, and surgical procedure related characteristics and fac...

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Autores principales: Rasulić, Lukas, Djurašković, Slavko, Lakićević, Novak, Lepić, Milan, Savić, Andrija, Grujić, Jovan, Mićić, Aleksa, Radojević, Stefan, Puzović, Vladimir, Maletić, Miloš, Mandić-Rajčević, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8716365/
https://www.ncbi.nlm.nih.gov/pubmed/34977143
http://dx.doi.org/10.3389/fsurg.2021.774411
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author Rasulić, Lukas
Djurašković, Slavko
Lakićević, Novak
Lepić, Milan
Savić, Andrija
Grujić, Jovan
Mićić, Aleksa
Radojević, Stefan
Puzović, Vladimir
Maletić, Miloš
Mandić-Rajčević, Stefan
author_facet Rasulić, Lukas
Djurašković, Slavko
Lakićević, Novak
Lepić, Milan
Savić, Andrija
Grujić, Jovan
Mićić, Aleksa
Radojević, Stefan
Puzović, Vladimir
Maletić, Miloš
Mandić-Rajčević, Stefan
author_sort Rasulić, Lukas
collection PubMed
description Radial nerve injuries are often associated with humeral shaft fractures. The results of treatment of these injuries, by contemporary surgical approaches, remain diverse. In this paper we presented the outcomes and analyzed the patient, clinical, and surgical procedure related characteristics and factors that may influence the outcome overall, in 77 patients treated at Clinic for Neurosurgery, Clinical Center of Serbia during a 20 years period. The nerve injuries were verified by US and EMNG. The majority of patients were treated by neurolysis or sural nerve grafting, while only few were treated by direct suture. The final recovery was evaluated by muscle strength assessment and classified using MRC. We analyzed extension of the wrist, extension of the fingers including the thumb, and abduction of the thumb. There was a significant statistical difference in MRC grade following the treatment. The total rate of useful functional recovery was achieved in 69 (89.61%) out of all studied patients, out of whom 20 (28.99%) achieved excellent recovery, 26 (37.68%) achieved good recovery and 23 (33.33%) achieved fair recovery. Only 8 (10.39%) out of all studied patients achieved poor recovery. The injured nerves, that were preserved in continuity, acquired by a low-energy trauma, and treated earlier than the 6 months were associated with better functional outcome following the surgery. In addition, there was a trend of better functional improvement with aging, keeping in mind that the old were subjected to lower energy trauma. The expectant management followed by surgery of radial nerve injury associated with humeral shaft fracture should be around 3 months, and the surgical nerve repair should not be performed later than the 6 months after injury. The energy of trauma may be a factor predicting patient's final recovery following the treatment.
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spelling pubmed-87163652021-12-31 Surgical Treatment of Radial Nerve Injuries Associated With Humeral Shaft Fracture—A Single Center Experience Rasulić, Lukas Djurašković, Slavko Lakićević, Novak Lepić, Milan Savić, Andrija Grujić, Jovan Mićić, Aleksa Radojević, Stefan Puzović, Vladimir Maletić, Miloš Mandić-Rajčević, Stefan Front Surg Surgery Radial nerve injuries are often associated with humeral shaft fractures. The results of treatment of these injuries, by contemporary surgical approaches, remain diverse. In this paper we presented the outcomes and analyzed the patient, clinical, and surgical procedure related characteristics and factors that may influence the outcome overall, in 77 patients treated at Clinic for Neurosurgery, Clinical Center of Serbia during a 20 years period. The nerve injuries were verified by US and EMNG. The majority of patients were treated by neurolysis or sural nerve grafting, while only few were treated by direct suture. The final recovery was evaluated by muscle strength assessment and classified using MRC. We analyzed extension of the wrist, extension of the fingers including the thumb, and abduction of the thumb. There was a significant statistical difference in MRC grade following the treatment. The total rate of useful functional recovery was achieved in 69 (89.61%) out of all studied patients, out of whom 20 (28.99%) achieved excellent recovery, 26 (37.68%) achieved good recovery and 23 (33.33%) achieved fair recovery. Only 8 (10.39%) out of all studied patients achieved poor recovery. The injured nerves, that were preserved in continuity, acquired by a low-energy trauma, and treated earlier than the 6 months were associated with better functional outcome following the surgery. In addition, there was a trend of better functional improvement with aging, keeping in mind that the old were subjected to lower energy trauma. The expectant management followed by surgery of radial nerve injury associated with humeral shaft fracture should be around 3 months, and the surgical nerve repair should not be performed later than the 6 months after injury. The energy of trauma may be a factor predicting patient's final recovery following the treatment. Frontiers Media S.A. 2021-12-16 /pmc/articles/PMC8716365/ /pubmed/34977143 http://dx.doi.org/10.3389/fsurg.2021.774411 Text en Copyright © 2021 Rasulić, Djurašković, Lakićević, Lepić, Savić, Grujić, Mićić, Radojević, Puzović, Maletić and Mandić-Rajčević. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Rasulić, Lukas
Djurašković, Slavko
Lakićević, Novak
Lepić, Milan
Savić, Andrija
Grujić, Jovan
Mićić, Aleksa
Radojević, Stefan
Puzović, Vladimir
Maletić, Miloš
Mandić-Rajčević, Stefan
Surgical Treatment of Radial Nerve Injuries Associated With Humeral Shaft Fracture—A Single Center Experience
title Surgical Treatment of Radial Nerve Injuries Associated With Humeral Shaft Fracture—A Single Center Experience
title_full Surgical Treatment of Radial Nerve Injuries Associated With Humeral Shaft Fracture—A Single Center Experience
title_fullStr Surgical Treatment of Radial Nerve Injuries Associated With Humeral Shaft Fracture—A Single Center Experience
title_full_unstemmed Surgical Treatment of Radial Nerve Injuries Associated With Humeral Shaft Fracture—A Single Center Experience
title_short Surgical Treatment of Radial Nerve Injuries Associated With Humeral Shaft Fracture—A Single Center Experience
title_sort surgical treatment of radial nerve injuries associated with humeral shaft fracture—a single center experience
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8716365/
https://www.ncbi.nlm.nih.gov/pubmed/34977143
http://dx.doi.org/10.3389/fsurg.2021.774411
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