Radial Nerve Palsy in Adult Traumatic Humeral Shaft Fractures: Epidemiology and Outcomes at a Level One Trauma Center | ||||
| The Egyptian Orthopaedic Journal | ||||
| Articles in Press, Accepted Manuscript, Available Online from 31 March 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/eoj.2025.357933.1006 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Youssef Sameh Yassin   ; Khaled M Balam; Amr A Fadle
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| Orthopedic Surgery Department, Faculty of Medicine, Assiut University, Assiut. Egypt. | ||||
| Abstract | ||||
| Introduction and Aim: Traumatic humeral shaft fractures are common injuries, often managed conservatively. However, surgical interventions are frequently employed to improve outcomes. Associated primary radial nerve palsy is about 22%. This study aims to evaluate the incidence and consequences of radial nerve palsy in adult patients with traumatic humeral shaft fractures admitted at Assiut University Hospital from April 2022 to March 2023. Patients and Methods: A prospective case series was conducted at a level I trauma center on 51 patients (age >16 years) with humeral shaft fractures. Exclusions included pathological fractures, old presentations, or intra-articular extensions. Patients were followed for six months. Results: The mean patient age was 37.4 years, and 80.4% were male. Road traffic accidents were the predominant cause (68.6%). Fractures were predominantly AO type A (66.6%). Surgical management included posterior plating (64.7%), anterior plating (13.7%), Long PHILOS (5.8%), MIPO (1.9%), EXFIX (5.8%), Conserve (3.9%). Union was achieved in 94% of cases with an average DASH score of 11.5. Radial nerve palsy occurred in 11 patients (21.57%): 8 primary (15.56%) and 3 iatrogenic (5.88%). Seven patients (63.6%) had spontaneous recovery within 4-6 months following surgical exploration. Four required tendon transfer. Conclusion: Radial nerve palsy was observed in 11 out of 51 patients (21.57%). Surgical exploration showed no visible abnormalities in recovering patients. The posterior approach was the most commonly used (33 cases), with the choice of approach based on fracture site and radial nerve involvement. Successful union was achieved in 94% of cases. | ||||
| Keywords | ||||
| Humeral shaft fractures; radial nerve injury; adults | ||||
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