ABSTRACT
PURPOSE: The purpose of this study was to assess recovery and clinical outcome in patients with primary or secondary radial nerve palsy following humeral shaft fracture. METHODS: We retrospectively assessed 102 patients (45 female and 57 male) with humeral shaft fracture and concomitant radial nerve palsy, who were followed up for 12 months. Patients were divided into two groups with primary or secondary radial nerve palsy depending on the onset. Muscle function was measured according to Daniels classification and degree of nerve damage was assessed by the Sunderland classification. RESULTS: The average time for onset of recovery after primary RNP was 10.5 ± 3.31 weeks, in the case of secondary RNP it was 8.9 ± 7.98 weeks (p < 0.05). Full recovery or significant improvement was achieved with average of 26.7 ± 8.86 weeks and 23.9 ± 6.04 weeks respectively (p < 0.05). Trauma mechanism and type of treatment had no significant influence on time of onset of recovery or time to full recovery (p < 0.904). CONCLUSION: Secondary RNP shows tendency for earlier recovery and is more commonly associated with ORIF.
Subject(s)
Humeral Fractures/complications , Radial Nerve/injuries , Radial Neuropathy/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Humeral Fractures/surgery , Male , Middle Aged , Prognosis , Radial Neuropathy/physiopathology , Recovery of Function , Retrospective Studies , Young AdultABSTRACT
A total of 20 patients with cold antibody hemolytic anemia were evaluated in a retrospective study of them, 15 had a monoclonal gammopathy of unknown significance (MGUS): 14 with MGUS of immunoglobulin M (IgM) subtype and 1 with immunoglobulin G subtype. One patient had smoldering Waldenström's macroglobulinemia, but four patients had no monoclonal protein and no evidence of lymphoma. However, in three of these patients, we were able to demonstrate a (mono-)clonal rearrangement of their immunoglobulin heavy and/or light chains. Of the 20 patients, 5 had IgHV34 nucleotide sequence indicating that the antibody was directed against the "I" antigen. Two patients exhibited a progressive increase of IgM over time, however without increasing hemolytic activity. Moreover, in two patients with long-term follow-up, we were able to correlate recurrent hemolytic activity with low environmental temperatures. Among four patients treated with rituximab, all four responded to treatment. However, treatment effect was only transient in all of them.
