- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Radial nerve palsy common in humoral shaft fracture has high recovery rates: Study
![Radial nerve palsy common in humoral shaft fracture has high recovery rates: Study Radial nerve palsy common in humoral shaft fracture has high recovery rates: Study](https://medicaldialogues.in/h-upload/2021/01/08/750x450_145556-fracture-in-women.webp)
In a recent study result published in the Journal of Shoulder and Elbow Surgery, researchers have highlighted that a high percentage of patients with humeral shaft fracture and experiencing radial nerve palsy, gain back nerve functionality with an average time period of 7 to 9 weeks.
Nerve palsy is common after humeral shaft fracture with the radial nerve being the most commonly injured nerve. Isolated nerve injuries usually recover spontaneously and operative intervention is rarely indicated.
The goal of the present study was to assess the predictors of traumatic nerve injury and recovery in a large cohort of patients with humeral shaft fractures.After obtaining IRB approval, 376 patients with humeral shaft fracture including 96 patients with documented traumatic nerve palsy and 280 with intact neurovascular exam on presentation were retrospectively included in the study. The primary outcome was incidence of a traumatic nerve palsy and the secondary outcome was nerve recovery.
Data analysis revealed some interesting facts.
· Nerve palsy was present in 96 (25.5%) patients at the time of injury. Radial nerve was the most commonly injured nerve (93.6%), followed by ulnar (5.1%), and axillary (1.2%) nerves. Seventeen patients (17.7%) had multiple nerves palsies.
· A multivariable regression analysis revealed that the concomitant vascular injury (OR: 52, 95% CI: 5.6-480.6), distal 1/3 fractures (OR: 6.3, 95% CI: 2.7-14.7) and middle 1/3 (OR: 2.8, 95% CI: 1.2-6.5) versus proximal fractures, open fracture (OR: 2.1, 95% CI: 1.1-4.4), and high-energy trauma (OR: 1.7, 95% CI: 1.1-2.9) were independent predictors of nerve palsy.
· Iatrogenic nerve injury was detected in 7 (4.6%) patients, all affecting the radial nerve.
· Spontaneous recovery of traumatic nerve injuries was detected in 87 (91%) patients with 19% partial and 72% complete recovery. Initial sign of recovery was observed at median times of 7 and 9 weeks for those managed conservatively or fracture fixation.
· Operative treatment of the fracture had no effect on the outcome of nerve recovery (88.5% vs. 100%; p=0.14). Ten (14.1%) patients had transected nerves at the time of exploration and open fractures (22.7% vs. 6.8%; p=0.04) and concomitant vascular injury (33.3% vs. 7.3%; p=0.02) were associated with nerve transection, portending a worse prognosis for nerve recovery compared to nerves in continuity (40% vs. 95.3%, p=0.004).
Observing the results, the team opined "The incidence of nerve injury after humeral shaft fracture was 25%, reflecting an abundance of high energy and open injuries in this cohort. Ninety one percent of patients experienced improvement in their nerve function with median time to recovery of 7-9 weeks. The operative treatment of the fracture did not change the rate of nerve recovery. Patients with multiple nerve palsies and concurrent vascular insult had worse nerve recovery. We recommend nerve studies if no sign of recovery is observed by 9 weeks."
For full article follow the link: https://doi.org/10.1016/j.jse.2021.04.025
Primary source: Journal of Shoulder and Elbow Surgery
Dr Satabdi Saha (BDS, MDS) is a practicing pediatric dentist with a keen interest in new medical researches and updates. She has completed her BDS from North Bengal Dental College ,Darjeeling. Then she went on to secure an ALL INDIA NEET PG rank and completed her MDS from the first dental college in the country – Dr R. Ahmed Dental College and Hospital. She is currently attached to The Marwari Relief Society Hospital as a consultant along with private practice of 2 years. She has published scientific papers in national and international journals. Her strong passion of sharing knowledge with the medical fraternity has motivated her to be a part of Medical Dialogues.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751