Radial Nerve Palsy in the Setting of Humeral Shaft Fracture.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Conflicts of Interest No benefits in any form have been received or will be received related directly to this article. 6. Biomed Res Int. 2023 Dec 1;2023:3974604. doi: 10.1155/2023/3974604. eCollection 2023. Radial Nerve Palsy Associated with Humeral Shaft Fractures in Children. Łukasz W(1)(2), Ryszard T(1)(3), Maria D(4). Author information: (1)Department of Trauma and Orthopaedic Surgery, Upper Silesian Children's Health Centre, Katowice, Poland. (2)Department of Trauma and Orthopedic Surgery, ZSM Hospital, Chorzów, Poland. (3)Faculty of Science and Technology, Institute of Biomedical Engineering, University of Silesia in Katowice, Katowice, Poland. (4)Department of Anaesthesiology and Intensive Care, Upper Silesian Child Health Centre, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland. BACKGROUND: This is the first systematic review of the relationship between humeral shaft fractures and radial nerve palsy in children. The present comprehensive review is aimed at identifying important clinical findings between humeral diaphysis fractures and radial nerve injuries and assessing the effects of treatment. METHODS: We searched electronic bibliographic databases, including PubMed, the Cochrane Library, Scopus, and Web of Knowledge, until March 2022. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the patients, interventions, comparisons, outcomes guidelines. RESULTS: We identified 23 original papers, of which 10 were eligible for further analysis. Cases of 32 young patients with radial nerve palsy were identified and analyzed. The prevalence of radial nerve palsy was 4.34% (eight cases out of 184 patients with humeral shaft fractures). The radial nerve was most often associated with a simple transverse fracture (12A3, 17 cases (65.4%)). CONCLUSIONS: Radial nerve injury in humeral shaft fractures in children is rare, with a frequency of 4.34%. We highly recommend early surgical nerve exploration with transverse fractures in the distal third segment combined with primary radial palsy. Furthermore, we recommend making thoughtful decisions regarding early nerve exploration in the Holstein-Lewis fractures. In addition, consideration of early surgical nerve exploration in fractures resulting from high-energy trauma and open fractures despite their morphology is recommended. Copyright © 2023 Wiktor Łukasz et al. DOI: 10.1155/2023/3974604 PMCID: PMC10708953