Incidence and Outcome of the Radial Nerve Injury following Open Fracture of the Humerus

Abstract

Background: Radial nerve injury is the most common peripheral nerve injury associated with humeral shaft fracture and can result in significant motor impairment of the arm and the wrist.

Objectives: To evaluate the incidence, pattern and outcome of the radial nerve injury following open fracture of the humerus.

Material and Methods: This is a multicentre cross-sectional descriptive study. It included all patients with radial nerve injuries following open fracture of the humerus presented to orthopaedic departments of the major hospitals in Khartoum State, Sudan during the period June 2009 - June 2013. Collected data were processed using SPSS computer package version 17.

Result: A total of 48 patients were included, 34 males and 14 females (ratio 1.5: 1). Mean age ± standard error of mean of 30.71 ± 1.78 years (ranged 4 – 64 years). About 60.4% of injuries were due to gunshot and 24 (50.0%) patients were from conflict areas. Most of the injuries were in left side in about 68.8% of patients. The common patterns of the humeral fractures associated with radial nerve injury were open comminuted and transverse of middle or distal part. Neurapraxia was common type of radial nerve injury in about 89.6%. About 91.7% of the patients were treated conservatively and 81.3% of them recovered completely.

Conclusions: Most of the radial nerve injuries following open fracture of the humerus were caused by gunshot injury in male soldiers mainly in the distal and middle parts. The fractures were mainly displaced comminuted and transverse types. The commonest type of radial nerve palsy was neurapraxia in 89.6% of cases. Most of the patients were treated conservatively and 81.3% of them recovered spontaneously after the first two months.

Keywords: Neurapraxia, Repair, Recovery, Gun shot, Sudan.