Humeral fractures sustained during arm wrestling.

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Abstract

[Indexed for MEDLINE] 13. Cureus. 2020 Nov 15;12(11):e11490. doi: 10.7759/cureus.11490. Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review. Hegeman EM(1), Polmear M(2), Scanaliato JP(3), Nesti L(4), Dunn JC(5). Author information: (1)Orthopaedic Surgery, Brooke Army Medical Center, San Antonio, USA. (2)Orthopaedics, William Beaumont Army Medical Center, El Paso, USA. (3)Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, USA. (4)Orthopaedic Surgery, Uniformed Services University of the Health Sciences, Bethesda, USA. (5)Orthopaedic Hand Surgery, William Beaumont Army Medical Center, El Paso, USA. Radial nerve palsies in closed humeral shaft fractures are common, with an incidence of 7%-17%. The management of radial nerve palsies in closed fractures is often expectant, with 70.7% spontaneously recovering within six months. A literature search was conducted for studies on radial nerve palsies in humeral shaft fractures from 2000-2018. A total of 4972 humeral shaft fractures were identified, with an incidence of 12.2% of primary radial nerve palsies. During the exploration, no neurological intervention was performed in nearly 41% of cases, and the most common finding was no evidence of any nerve lesion (35%). Those who underwent neurolysis were more likely to resolve when compared to primary repair or nerve grafting. Overall, there was a high rate of spontaneous radial nerve palsy recovery (85%) with radial nerve exploration increasing rates of resolution. While exploration demonstrates increased resolution, it is yet to be determined which fractures are indicated for nerve exploration. Copyright © 2020, Hegeman et al. DOI: 10.7759/cureus.11490 PMCID: PMC7736027