Radial nerve palsy with fracture shaft of the humerus treated with early limited nerve exploration and internal fixation.

ABSTRACT

Background and Objective: Radial nerve injuries associated with fractures of the humerus are the most common peripheral nerve injuries in long bone fractures. Management of these injuries remains controversial. Strong convictions for and against either line of treatment - conservative or operative can be drawn from the literature. This study evaluates the role of early limited exploration in these injuries. Methods: Sixteen patients with radial nerve palsy with fracture shaft of humerus treated with open reduction and internal fixation with plates were studied. Follow up of the patients was done with regard to intraoperative findings and pattern of recovery. Results: Radial nerve continuity with spontaneous clinical recovery was seen in all of our cases. The average time for onset of recovery in our study was two weeks for neurapraxia and 22 weeks for axonotmesis. The average time for complete recovery was five weeks for neurapraxia and 30 weeks for axonotmesis. 88% of our cases showed excellent and 12% showed good results. Conclusions and interpretation: Limited early nerve exploration of radial nerve is a reliable option while performing internal fixation for both primary as well as secondary radial nerve palsy with fracture of shaft of humerus.