Modalities of Management of Radial Nerve Injury presented with Fracture in different Sites of Humerus

Abstract

Background :This topic has been the subject of interest for many authors for many years, because still there is a recurrent theme …should the nerve be explored routinely along with internal fixation of fracture  or should exploration be limited to those cases in which spontaneous recovery has not occurred within expected time ?  or when justify?   

Objectives: This study is designed is to shed a light on the dilemma  of  management  radial nerve injury, in surgically treated patients versus conservatively treated others .

Methods : A series of   25  patients presented with any degree of radial nerve palsy complicating140 case of closed fracture shaft humerus , were  treated by surgical & conservative method , according to certain indicators  and evaluated during three years period, in two teaching hospital in Baghdad,  from 2006 to  2008. Most of patients were males  19  case & the remaining patients were females 6 cases ,their age ranging from 3 days old baby to 45 years old & the mean age was 25 years .Ten (10)  patients treated conservatively , Fifteen (15 ) patient  treated surgically by either early  exploration ( too early &  late early ) or  delayed exploration.

Results: The radial nerve was explore in seventeen patients from total number of study  25 patients. Eight treated by early exploration .. ( five by too early exp. within few days & three by late early exp. within next two weeks).Nine patients treated by delayed exploration after ( 3.5~ 4 ) months post traumatic period .In the last eight patients , the radial nerve was not explored & treated conservatively? The overall useful recovery rate from applying our policy was (84 % ).

Conclusion: Treatment of radial nerve palsy complicated closed fracture shaft humerus should be programmed well, depending on many factors , such as severity & onset of nerve lesion and type & site of associated fractures.