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Analysis of outcome following early exploration of radial nerve palsy associated with closed shaft of humerus fractures
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| Author:
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SUGUMAR N, J. BENJAMIN VINODH, ARCHA ANNA
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| Abstract:
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The aim of the study was to determine the outcome of early surgical exploration of the injured radial nerve associated with closed shaft of humerus fractures. This single-center prospective study was done among 32 patients who had primary radial nerve palsy following humerus diaphyseal fracture. The study was done over a period of 2 and a half years (2017-2019). Early surgical exploration was done in all patients having an associated radial nerve palsy and they were followed up for 1 year. Among 32 patients, 26 patients (81.25%) had Neuropraxia, 4 patients (12.5%) had Axonotmesis and 2 patients (6.25%) had Neurotmesis. Immediate intervention (Epineurial neurorrhaphy) was done for the 2 patients who had neurotmesis. Though literature supports both immediate exploration and expectant policy, on our experience we came across neurotmesis of the radial nerve in closed fracture of the humerus and there are few other case reports regarding the same too. Since we obtained satisfactory results, early exploration of affected nerve with stable internal fixation of the fracture is a safe and reliable choice of treatment in closed humerus diaphyseal fracture with radial nerve palsy as it provides knowledge on the anatomy of the nerve, the extent of nerve injury after fracture, access to immediate intervention for the same if needed, helps in early mobilization of the limb and reduces the need for re-surgeries on a later date which might end in poor prognosis when compared to early exploration.
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| Keyword:
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Early exploration; Radial nerve palsy; Shaft of humerus closed fracture; Neurotmesis; DASH score; Epineurial neurorrhaphy
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| EOI:
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-
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| DOI:
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https://doi.org/10.31838/ijpr/2021.13.01.440
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| Download:
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