title: Review of literature of radial nerve injuries associated with humeral fractures-an integrated management strategy.
abstract: BACKGROUND
  Radial nerve palsy associated with fractures of the shaft of the humerus is the most common nerve lesion complicating fractures of long bones. However, the management of radial nerve injuries associated with humeral fractures is debatable. There was no consensus between observation and early exploration.
  
  
  RESULTS
  The PubMed, Embase, Cochrane Central Register of Controlled Trials, Google Scholar, CINAHL, International Bibliography of the Social Sciences, and Social Sciences Citation Index were searched. Two authors independently searched for relevant studies in any language from 1966 to Jan 2013. Thirty studies with 2952 humeral fractures participants were identified. Thirteen studies favored conservative strategy. No significant difference between early exploration and no exploration groups (OR, 1.03, 95% CI 0.61, 1.72; I(2) = 0.0%, p = 0.918 n.s.). Three studies recommend early radial nerve exploration in patients with open fractures of humerus with radial nerve injury. Five studies proposed early exploration was performed in high-energy humeral shaft fractures with radial nerve injury.
  
  
  CONCLUSIONS
  The conservative strategy was a good choice for patients with low-energy closed fractures of humerus with radial nerve injury. We recommend early radial nerve exploration (within the first 2 weeks) in patients with open fractures or high-energy closed fractures of humerus with radial nerve injury.
authors.affiliation: Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, PR China.
authors.forename: YuLin
authors.initials: Y
authors.lastname: Li
authors.forename: GuangZhi
authors.initials: G
authors.lastname: Ning
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wu
authors.forename: QiuLi
authors.initials: Q
authors.lastname: Wu
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: ShiQing
authors.initials: S
authors.lastname: Feng
mesh_terms: D019468:Disease Management; D006801:Humans; D006810:Humeral Fractures / Q000150:complications / Q000503:physiopathology*; D039781:PubMed; D011826:Radial Nerve / Q000293:injuries* / Q000503:physiopathology; D020425:Radial Neuropathy / Q000453:epidemiology / Q000503:physiopathology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy