Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2021; 9(27): 8044-8050
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8044
Radial nerve recovery following closed nailing of humeral shaft fractures without radial nerve exploration: A retrospective study
Kuei-Lin Yeh, Chen-Kun Liaw, Tai-Yin Wu, Chung-Pei Chen
Kuei-Lin Yeh, Department of Orthopedics, Shin Kong Wu-Ho Su Memorial Hospital, Taipei City 111, Taiwan
Chen-Kun Liaw, Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 11031, Taiwan
Chen-Kun Liaw, Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
Chen-Kun Liaw, Graduate Institute of Biomedical Optomechatronics, College of Biomedical Engineering; Research Center of Biomedical Device, Taipei Medical University, Taipei City 11301, Taiwan
Tai-Yin Wu, Department of Family Medicine, Zhongxing Branch, Taipei City Hospital, Taipei City 10341, Taiwan
Tai-Yin Wu, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei City 10055, Taiwan
Tai-Yin Wu, National Taipei University of Nursing and Health Science, Taipei City 11219, Taiwan
Chung-Pei Chen, Department of Orthopedics, Cathay General Hospital, New Taipei City 221, Taiwan
Author contributions: Yeh KL and Chen CP designed and performed the experiments, provided essential mouse strains, analyzed the data, supervised the research, and cowrote the manuscript; Liaw CK, Wu TY, and Yeh KL performed the experiments; Chen CP, Wu TY, and Liaw CK conducted the transporter experiments; Yeh KL, Chen CP, and Wu TY performed the metabolomic analyses; Liaw CK, Yeh KL, and Wu TY designed the experiments and cowrote the manuscript.
Institutional review board statement: This study was approved by the institutional review board of Shin Kong Wu Ho-Su Memorial Hospital on August 4, 2020 (Approval Number: 20200706R).
Informed consent statement: The requirement for informed consent was waived owing to the retrospective study design.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author at nowfornever@gmail.com. All participants provided informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chung-Pei Chen, MD, Doctor, Department of Orthopedics, Cathay General Hospital, No. 2 Lane. 59, Jiancheng Road, Xizhi District, New Taipei City 221, Taiwan. nowfornever@gmail.com
Received: April 15, 2021
Peer-review started: April 15, 2021
First decision: April 27, 2021
Revised: May 8, 2021
Accepted: August 20, 2021
Article in press: August 20, 2021
Published online: September 26, 2021
Processing time: 153 Days and 19.5 Hours
Abstract
BACKGROUND

Radial nerve palsy due to humeral shaft fracture is the most common peripheral nerve injury associated with long bone fractures. An antegrade nailing surgical technique is becoming popular for the fixation of these fractures with minimal invasiveness. We analyzed nerve recovery in patients with humeral shaft fracture and radial nerve palsy treated with humeral nail fixation without nerve exploration.

AIM

To assess the radial nerve recovery rate and time from humeral shaft fracture with surgical treatment using close nailing.

METHODS

We retrospectively collected data of patients who underwent undergone surgical nail fixation for humeral shaft fractures between October 1, 2016, and March 31, 2020. Subsequently, we analyzed the primary or secondary radial nerve palsy recovery rate and radial nerve motor function recovery time.

RESULTS

The study included 70 patients who underwent surgical treatment for closed- or Gustilo type I open humeral shaft fractures using a nail fixation technique without radial nerve exploration. The patients suffered from primary (n = 5) and secondary (n = 5) radial nerve palsy. A 100% radial nerve recovery rate was achieved. The mean recovery time was 4.3 mo.

CONCLUSION

The study results indicate full recovery of radial nerve palsies from humeral shaft fracture using close nailing treatment. Surgeons need not be concerned about the occurrence of permanent nerve palsies.

Keywords: Humeral shaft fracture; Radial nerve palsy; Close nailing fixation; Nerve exploration

Core Tip: The study results indicate full recovery of radial nerve palsies from humeral shaft fracture using close nailing treatment. Surgeons need not be concerned about the occurrence of permanent nerve palsies.