Articles Tập 67 Số CĐ14-HNKH Hội Hóa sinh Y học Việt Nam 17/09/2026

RADIAL NERVE INJURY IN CLOSED HUMERAL SHAFT FRACTURES: CHARACTERISTICS AND OUTCOMES AFTER LOCKED PLATE FIXATION

Tran Quoc Doanh, Pham Ngoc Thang, Nguyen Anh Sang
DOI: 10.52163/yhc.v67iCD14.6579
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Abstract

Objective: To determine the incidence, intraoperative characteristics, and recovery pattern of radial nerve injury, and to evaluate its impact on functional outcomes following locked plate fixation.

Subject and methods: A retrospective and prospective study was conducted on 58 patients with closed humeral shaft fractures treated with locked plate fixation at Military Hospital 175 from January 2022 to August 2025. Variables included preoperative radial nerve status, intraoperative findings, management strategies, recovery progression, and functional outcomes assessed by DASH score 12 months post-surgery.

Results: The incidence of preoperative radial nerve injury was 10.3%. Intraoperatively, all injuries were neurapraxia or contusion. Complete recovery was achieved in 100% of prospective cases by 3 months, with no residual deficits at 12 months post-surgery. There was no significant difference in DASH scores between patients with and without radial nerve injury (p = 0.387).

Conclusion: In this study, radial nerve injury in closed humeral shaft fractures showed a high reversibility in cases of incomplete injury. Locked plate fixation combined with nerve release provides excellent recovery and does not negatively affect long-term functional outcomes.

Keywords
Humeral shaft fracture, nerve injury, radial nerve, closed fracture, surgery.
References
[1]
[1] Court-Brown C.M, Caesar B. Epidemiology of adult fractures: a review. Injury, 2006, 37 (8): 691-7. doi: 10.1016/j.injury.2006.04.130 Google Scholar
[2]
[2] Bergdahl C, Ekholm C, Wennergren D, Nilsson F, Möller M. Epidemiology and patho-anatomical pattern of 2,011 humeral fractures: data from the Swedish Fracture Register. BMC Musculoskelet Disord, 2016, 17: 159. doi: 10.1186/s12891-016-1009-8 Google Scholar
[3]
[3] Li Y, Ning G, Wu Q, Wu Q, Li Y, Feng S. Review of literature of radial nerve injuries associated with humeral fractures - an integrated management strategy. PloS One, 2013, 8 (11): e78576. doi: 10.1371/journal.pone.0078576 Google Scholar
[4]
[4] Shao Y.C, Harwood P, Grotz M.R, Limb D, Giannoudis P.V. Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review. J Bone Joint Surg Br, 2005, 87 (12): 1647-52. doi: 10.1302/0301-620x.87b12.16132 Google Scholar
[5]
[5] Cuello C.M.C, Jesus O.D. Neurapraxia: Treasure Island (FL). StatPearls Publishing, 2023. Google Scholar
[6]
[6] Nadi M, Dabbas W, Das JM. Peripheral Nerve Injury: Treasure Island (FL). StatPearls Publishing, 2026. Google Scholar
[7]
[7] Benjamin K.B, Kushagra M, Matthew A.V. Radial nerve entrapment: Treasure Island (FL). StatPearls Publishing, 2023. Google Scholar
[8]
[8] Gragossian A, Varacallo M.A. Radial Nerve Injury: Treasure Island (FL). StatPearls Publishing, 2023. Google Scholar
[9]
[9] Ilyas A.M, Mangan J.J, Graham J. Radial nerve palsy recovery with fractures of the humerus: an updated systematic review. J Am Acad Orthop Surg, 2020, 28 (6): e263-e9. doi: 10.5435/jaaos-d-18-00142 Google Scholar
[10]
[10] Van Bergen S.H, Van Lieshout E.M.M, Verhofstad M.H.J, Den Hartog D. Recovery and functional outcome after radial nerve palsy in adults with a humeral shaft fracture: a multicenter prospective case series. JSES Int, 2023, 7 (3): 516-22. doi: 10.1016/j.jseint.2023.02.003 Google Scholar