Postoperative iatrogenic radial nerve palsy in open reduction internal fixation of humeral shaft fractures

2016-09-29T17-57-18Z
Source: Rawal Medical Journal
Muhammad Inam, Ismail Khan, Ihsanullah, Mohammad Saeed.
Objective: To determine the frequency of postoperative iatrogenic radial nerve palsy in open reduction internal fixation of humeral shaft fractures. Methodology: In this descriptive cross sectional study, a total of 41 humerus shaft fractures were treated surgically at Orthopedic Department, Hayatabad Medical Complex, Peshawar, Pakistan over a period of one year from September 2014 to august 2015. The frequency of postoperative iatrogenic radial nerve palsy were noted among these patients. Results: Of the 41 patients, 10 were female and 32 were male. The median age was 32 years (range, 20-65 years). Out of these, 35 patients had been treated with dynamic compression plates and six with locking compression plates. All fractures were diaphyseal, at the middle or distal third level. Four (9.8%) patients developed iatrogenic radial nerve palsy. In them, the radial nerve was in continuity and no macroscopic lesions were noted. The median time to the beginning of clinical recovery was 16 weeks (range, 525 weeks). The timing and pattern of radial nerve recovery in this situation was similar to that seen in primary radial nerve palsy. Conclusion: Post-operative radial nerve palsy is almost always transient and recovers with the passage of time with patient reassurance and dynamic splint in extend position of the wrist and fingers. Open reduction internal fixation provides greater patient comfort and is a good alterna-tive to conservative treatment, as unnecessary avoidance of open reduction internal fixation in fear of iatrogenic radial nerve palsy, unemployment of the patient and prolongs limb rehabilitation.


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