title: Causes of Secondary Radial Nerve Palsy and Results of Treatment.
abstract: BACKGROUND The aim of this study was to analyze the causes that lead to secondary damage of the radial nerve and to discuss the results of reconstructive treatment. MATERIAL AND METHODS The study group consisted of 33 patients treated for radial nerve palsy after humeral fractures. Patients were diagnosed based on clinical examinations, ultrasonography, electromyography, or nerve conduction velocity. During each operation, the location and type of nerve damage were analyzed. During the reconstructive treatment, neurolysis, direct neurorrhaphy, or reconstruction with a sural nerve graft was used. The outcomes were evaluated using the Medical Research Council (MRC) scales and the quick DASH score. RESULTS Secondary radial nerve palsy occurs after open reduction and internal fixation (ORIF) by plate, as well as by closed reduction and internal fixation (CRIF) by nail. In the case of ORIF, it most often occurs when the lateral approach is used, as in the case of CRIF with an insertion interlocking screws. The results of the surgical treatment were statistically significant and depended on the time between nerve injury and revision (reconstruction) surgery, type of damage to the radial nerve, surgery treatment, and type of fixation. Treatment results were not statistically significant, depending on the type of fracture or location of the nerve injury. CONCLUSIONS The potential risk of radial nerve neurotmesis justifies an operative intervention to treat neurological complications after a humeral fracture. Adequate surgical treatment in many of these cases allows for functional recovery of the radial nerve.
authors.affiliation: Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wrocław Medical University, Wrocław, Poland.
authors.forename: Pawel
authors.initials: P
authors.lastname: Reichert
authors.affiliation: Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wroclaw Medical University, Wrocław, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Wnukiewicz
authors.affiliation: Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wroclaw Medical University, Wrocław, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Witkowski
authors.affiliation: Centre of Veterinary Medicine JU-UAK, The University of Agriculture, Cracow, Poland.
authors.forename: Aneta
authors.initials: A
authors.lastname: Bocheńska
authors.affiliation: Faculty of Health Science, Department of Public Health, Wrocław Medical University, Wrocław, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Mizia
authors.affiliation: Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wrocław Medical University, Wrocław, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Gosk
authors.affiliation: Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wrocław Medical University, Wrocław, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zimmer
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011826:Radial Nerve / Q000473:pathology / Q000601:surgery*; D020425:Radial Neuropathy / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult