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Journal of Orthopaedic Trauma 2016-May

Iatrogenic Radial Nerve Palsy After Humeral Shaft Nonunion Repair: More Common Than You Think.

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Rafael Kakazu
Steven K Dailey
Amanda J Schroeder
John D Wyrick
Michael T Archdeacon

Keywords

Abstract

OBJECTIVE

To determine the rate of iatrogenic radial nerve palsy (RNP) after surgical repair of established humeral shaft nonunion (HSNU).

METHODS

Retrospective chart review.

METHODS

Level I trauma center.

METHODS

Fifty-four patients with HSNU, 10 (18.5%) of whom developed an iatrogenic RNP after nonunion repair.

METHODS

HSNU repair with compression plate stabilization with or without autogenous bone graft.

METHODS

Postoperative iatrogenic RNP.

RESULTS

Ten (18.5%) patients developed iatrogenic radial nerve palsies: 8 experienced complete resolution (mean, 2.5 months) and 2 experienced partial resolution. There were no statistically significant differences between patients who developed nerve palsy and those who did not in regard to age, gender, tobacco use, diabetic status, previous RNP, initial management (operative vs. nonoperative), surgical approach, presence of infected nonunion, number of previous surgeries, or operative time (P > 0.05).

CONCLUSIONS

The occurrence of iatrogenic RNP for patients undergoing surgical repair of an HSNU was 18.5%. According to historical data, this rate is nearly 3 times higher than for those undergoing open reduction and internal fixation of either acute humeral shaft fractures or HSNUs.

METHODS

Therapeutic Level IV. See Instructions for Authors for a complete description of Levels of Evidence.

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