Radial Nerve Injuries in Humeral Shaft Fractures: Experience of a Tertiary Hospital

Abstract

Background: The statistically relevant association of humeral diaphyseal fracture and radial nerve injury, mainly due to the anatomical path of this nerve is still one of the main factors of discussion nowadays since it is not a lesion with high incidence, which does not have a established and accepted protocols for its management. This, consequently, results in a spectrum of functional outcomes for patients who present with radial nerve injury associated with diaphyseal fracture. Objective: This study aimed to evaluate the patients treated in our emergency service with humeral diaphyseal fracture and associated radial nerve injury. Methods: A retrospective study based on the review of medical records that analyzed all patients who were seen in our emergency unit from January 2015 to July 2022 and who had a humeral diaphyseal fracture associated with radial nerve injury. Evaluating the patient's variables, inherent to trauma and fracture personality, association with radial nerve injury, and subsequent management. Thus, 80 patients were eligible for this study, 23 women and 57 men. Results: There was no statistical difference between Radial Nerve Injury and AO Classification (p=0.188; Chi-Square test), trauma mechanism (p=0.832; Chi-Square test), postoperative complications (p=0.087; Chi-Square test), gender (p=0.288; Chi-Square test), surgical re-approach (p=0.264; Chi-Square test), use of the implant chosen for definitive osteosynthesis (p=0.684; Chi-square test) and open fracture (p=0.100; Chi-square test). However, we observed a statistical difference in the use of external fixators (p=0.008; Chi-square test). Conclusion: Neuropraxia occurs by the mechanism of trauma, soft tissue damage, an inadvertent technique of a minimally invasive bridge plate, or by the incorrect Schanz positioning (external fixator), causing iatrogenic nerve damage.