OBJECTIVETo summarize clinical outcomes of using medial transposition of the radial nerve in humeral shaft fracture fixation.

METHODSFrom January 2005 to December 2009, 16 patients with humeral shaft fractures were treated with medial transposition of the radial nerve during open reduction and anterolateral plate fixation, included 12 males and 4 females ranging in age from 26 to 49 years, with a mean of 36 years. There were 7 fractures in the right and 9 in the left. According to AO classification, 6 fractures were type A3.2, 5 fractures were type A2.2, 2 fractures were type A1.2 and 3 fractures were type B2.2. The results were evaluated with DASH (disability of arm-shoulder-hand) Questionnaire by the American Academy of Orthopedic Surgeons (AAOS), where 0 indicates normal upper extremity function, and 1 to 100 indicate varying degrees of damage to the function of the upper extremities.

RESULTSThere was no neurologic complication or postoperative would infection in this series. The followed-up period ranged from 20 to 46 (means 29) months postoperatively. The clinical outcomes were evaluated with DASH Questionnaire, indicating that all patients reached a normal value (value of 0). The function of the upper extremities recovered satisfactorily. There was no surgery-related complication.

CONCLUSIONMedial transposition of the radial nerve is safe and does not cause iatrogenic nerve injury. It protects the radial nerve during open reduction and anterolateral plate fixation of humeral shaft fractures.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Radial Nerve ; surgery

Great importance and caution should be placed on prosthetic fitting for a paraplegic patient with an anesthetic residual limb if functional ambulation is to be achieved. The combination of paraplegia with a transfemoral amputation and radial nerve palsy is a complex injury that makes the rehabilitation process difficult. This article describes a case of L2 paraplegia with a transfemoral amputation and radial nerve palsy on the right side. Following the rehabilitation course, the patient independently walked using a walker at indoor level with a transfemoral prosthesis with ischial containment socket, polycentric knee assembly, endoskeletal shank and multiaxis foot assembly and a knee ankle foot orthosis on the sound side. The difficulties of fitting a functional prosthesis to an insensate limb and the rehabilitation stages leading to functional ambulation are reviewed.
Adult ; Amputation* ; Artificial Limbs* ; Case Report ; Femur/surgery* ; Human ; Male ; Paraplegia/rehabilitation* ; Radial Nerve*

Radial nerve palsy is the most common neurological involvement in humeral shaft fractures. But combined radial and median nerve injury in a closed diaphyseal fracture of the humerus is rare. Combined injury to both radial and median nerve can cause significant disability. A detailed clinical examination is therefore necessary following humeral shaft fractures. We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3) together with radial and median nerve palsy, its management and review of the literature. As the patient had two nerves involved, surgical exploration was planned. Fracture was reduced and fixed with a 4.5 mm narrow dynamic compression plate. There was no external injury to both radial and median nerves on surgical exploration. Neurological recovery started at 3 weeks' follow-up. Complete recovery was seen at 12 weeks. Careful clinical examination is of the utmost importance in early diagnosis of combined nerve injuries, which allows better management and rehabilitation of the patient.
Bone Plates ; Humans ; Humeral Fractures ; surgery ; Humerus ; Median Nerve ; Radial Neuropathy

Accessory Nerve ; transplantation ; Birth Injuries ; complications ; surgery ; Brachial Plexus Neuropathies ; etiology ; surgery ; Child, Preschool ; Early Medical Intervention ; Elbow ; Humans ; Infant ; Intercostal Nerves ; transplantation ; Nerve Transfer ; methods ; Radial Nerve ; surgery ; Sural Nerve ; transplantation ; Time Factors ; Treatment Outcome ; Ulnar Nerve ; transplantation

OBJECTIVETo investigate the method of medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus.

METHODSFrom January 2010 to December 2013,31 patients with medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus, including 18 males and 13 females ranging in age from 26 to 58 years old with a mean of 37 years old. The time between injury and operation was 1 to 8 days with an average of 4.5 days. According to AO classification, 7 fractures were type A1, 3 fractures were type A2, 6 fractures were type A3, 2 fractures were type B1, 4 fractures were type B2, 2 fractures were type B3, 4 fractures were type C, 3 fractures were type C2. No patients had any signs of radial nerve injury. The results were evaluated with DASH (disability of arm-shoulder-hand) Questionnaire by the American Academy of Orthopedic Surgeons (AAOS) which 0 indicated normal upper extremity function, and 1 to 100 indicated varying degrees of damage to the function of the upper extremties.

RESULTSThere was no neurologic complication or postoperative wound infection in this series. The followed-up period ranged form 8 to 15 months (means 11 months) postoperatively. The clinical outcomes were evaluated with DASH Questionnaire, the score before operation was 76.2±11.8, the final follow-up score was 8.2±7.4, the final follow-up score was significant higher than before operation (P<0.01). The function of the upper extremities recovered satisfactorily.

CONSLUSIONThe method of medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus can avoid iatrogenic radial nerve injury effectively.

Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Humerus ; innervation ; surgery ; Male ; Middle Aged ; Radial Nerve ; injuries ; surgery

OBJECTIVETo investigate the surgical treatment of mid-distal humeral shaft fractures associated with radial nerve palsysis with minimal invasive screwed nails osteosynthesis technique.

METHODSThirty-six patients treated mid-distal humeral shaft fractures associated with radial nerve palsysis from January 2004 to January 2008. There were 28 males and 8 females whose age ranged from 20- to 58-years-old with an average of 36.5-years-old. Injury reasons: mechanical injury 18 cases, traffic injury 8 cases, accidents injury 10 cases, all cases were closed fracture. According to AO/ASIF classification, type A1 5 cases, type A2 7 cases, type B1 8 cases, type B2 7 cases, type B3 5 cases, type C3 4 cases. The small lateral incision was performed located to the fracture. After exploration of the radial nerve, the fractures were reduced. By acromion small lateral incision, the deltoid was separated. In the posterior macronodular slotted antegrade reamed bored with medullary cavity drill and selected a suitable screwed nail screwed into the medullary cavity distal. Along the slot, the locking pieces were inserted to complete the fixation. The postoperative complication, fracture healing time, radial nerve function recovery time, the motion of shoulder and elbow were recorded.

RESULTSThe incision of all cases healed with stage I . The patients were followed up for 9-36 weeks with an average of 18.5 weeks. The X-ray examination showed fractures healing in 12-16 weeks (average of 15.6 weeks). Radial nerve function recovered fully at 12-36 weeks after operation (average of 17.8 weeks). Shoulder abduction is 150 degrees-170 degrees with an average of 160 degrees; elbow motion of activities was 130 degrees-140 degrees with an average of 135 degrees. The ASES method was used to assess the shoulder joint function, 20 cases gained the excellent result, 12 good and 4 poor. And according to HSS method, 36 cases of elbow joint function gained the excellent result.

CONCLUSIONThe surgical treatment of mid-distal humeral shaft fractures associated with radial nerve palsysis with minimal invasive screwed nails osteosynthesis technique is effective.

Adult ; Bone Nails ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Humeral Fractures ; surgery ; Humerus ; injuries ; innervation ; surgery ; Internal Fixators ; Male ; Paralysis ; surgery ; Radial Nerve ; pathology ; Young Adult

A case of macrodactyly associated with neurofiborma of the median nerve, a congenital anomaly of the hand, affecting only one(left middle) finger is reported with a review of the literature. Macrodactyly which is also termed local gigantism, megalodactylism, megalodactylia, or macrodactylism in other literature, is a rare congenital malformation characterized by overgrowth of one or more fingers of hand. Macrodactyly associated with neurofibroma of the median nerve is especially rare. For this reason the following case is presented together with a review of the literature.
Adolescent ; Angiography ; Female ; Fingers/abnormalities* ; Fingers/radiography ; Fingers/surgery ; Human ; Korea ; Median Nerve*/surgery ; Neurofibroma/complications* ; Neurofibroma/pathology ; Neurofibroma/surgery ; Peripheral Nervous System Neoplasms/complications* ; Peripheral Nervous System Neoplasms/pathology ; Peripheral Nervous System Neoplasms/surgery ; Radial Nerve/surgery

Adult ; Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; Humans ; Humeral Fractures ; complications ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radial Nerve ; diagnostic imaging ; injuries ; Radiography