Surgical resuls of opend reduction and plating of humeal shaft fractures assotiated with radial nerve palsy

ABSTRACT

The purpose of the present study was to assess early surgery in fractures humerus with radial nerve palsy versus conservative treatment. Nine patients with immediate complete radial nerve palsy complicating a fracture of the shaft of the humerus were reviewed. In all patients the radial nerve was explored and the fracture was fixed within one to two weeks of the accident. At exploration, interposition between the bone fragments or lacerations of the radial nerve was found in all fractures. The mean follow-up time was 9 months [range, 4-15]. There were 6 men and 3 women [mean age 39.1 years, 16 - 76]. There were 3 fractures of the mid-third and 6 fractures of the distal third of the humerus. All patients had complete return of radial-nerve function within three to six months after surgical exploration. This study confirms that radial nerve palsy is found especially in fractures located at the junction of the middle and the distal third of the humeral shaft. Because we found nearly always a macroscopically lesion of the nerve in this type of fracture, we believe an early exploration in spiriod fractures at that junction is better than conservative method: