Vol. 6, Issue 1, Part A (2024)

Background: Humeral shaft fractures, representing 3% of all fractures, have a bimodal distribution: low-energy falls in older adults and high-energy trauma in younger individuals. Radial nerve palsy (RNP) is a significant complication, with secondary RNP occurring in 10-20% of cases. This study examines the prevalence of secondary RNP following surgery for closed humeral shaft fractures and compares outcomes between radial nerve (RN) exploration and non-exploration.
Patients and Methods: This analytical cross-sectional study, conducted at Al-Yarmouk Teaching Hospital from April 2023 to April 2024, compared two surgical techniques for closed humeral shaft fractures: Open Reduction and Internal Fixation (ORIF) with and without RN exploration. It involved 38 adult patients, aged 18-60, divided into two groups: Group A (ORIF with RN exploration, n=22) and Group B (ORIF without RN exploration, n=16). Data collection included clinical assessments, radiological evaluations, and surgical observations. Statistical analysis was performed using SPSS, with ethical approval and informed consent obtained from all participants, adhering to national and international guidelines.
Results: In a study of 38 humeral shaft fractures treated with ORIF, 16% developed RNP. RN exploration during surgery did not significantly affect RNP rates (13.6% with exploration vs. 18.8% without, p=0.670). The average age of patients with RNP was 33.83 years, similar to those without RNP (36.44 years, p=0.608). The majority were male (71.1%), with Type A fractures being the most common (63.2%). RNP rates did not differ significantly by gender, fracture type, or level (p-values: 0.215, 0.540, and 0.736, respectively).
Conclusions: The study found a 16% incidence of RNP in patients with closed humeral shaft fractures treated with ORIF. No significant difference in RNP rates was observed between patients with or without RN exploration, and demographic factors or fracture characteristics did not affect RNP occurrence. Future research with larger samples and alternative techniques may be beneficial.