JSES International (May 2023)
Recovery and functional outcome after radial nerve palsy in adults with a humeral shaft fracture: a multicenter prospective case series
- Saskia H. Van Bergen, BSc,
- Esther M.M. Van Lieshout, PhD, MSc,
- Michael H.J. Verhofstad, MD, PhD,
- Dennis Den Hartog, MD, PhD,
- Ivo Beetz, MD, PhD,
- Hugo W. Bolhuis, MD,
- P. Koen Bos, MD, PhD,
- Maarten W.G.A. Bronkhorst, MD, PhD,
- Milko M.M. Bruijninckx, MD,
- Jeroen De Haan, MD, PhD,
- Axel R. Deenik, MD, PhD,
- P. Ted Den Hoed, MD, PhD,
- Martin G. Eversdijk, MD,
- J. Carel Goslings, MD, PhD,
- Robert Haverlag, MD,
- Martin J. Heetveld, MD, PhD,
- Albertus J.H. Kerver, MD, PhD,
- Karel A. Kolkman, MD,
- Peter A. Leenhouts, MD, MBA,
- Kiran C. Mahabier, MD, PhD,
- Sven A.G. Meylaerts, MD, PhD,
- Ron Onstenk, MD,
- Martijn Poeze, MD, PhD,
- Rudolf W. Poolman, MD, PhD,
- Bas J. Punt, MD,
- Ewan D. Ritchie, MD,
- W. Herbert Roerdink, MD, PhD,
- Gert R. Roukema, MD,
- Jan Bernard Sintenie, MD,
- Nicolaj M.R. Soesman, MD,
- Edgar J.T. Ten Holder, MD,
- Wim E. Tuinebreijer, MD, PhD,
- Maarten Van der Elst, MD, PhD,
- Frank H.W.M. Van der Heijden, MD, PhD,
- Frits M. Van der Linden, MD,
- Peer Van der Zwaal, MD, PhD,
- Jan P. Van Dijk, MD,
- Hans-Peter W. Van Jonbergen, MD, PhD,
- Egbert J.M.M. Verleisdonk, MD, PhD,
- Jos P.A.M. Vroemen, MD, PhD,
- Marco Waleboer, MD,
- Philippe Wittich, MD, PhD,
- Wietse P. Zuidema, MD
Affiliations
- Saskia H. Van Bergen, BSc
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Esther M.M. Van Lieshout, PhD, MSc
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Michael H.J. Verhofstad, MD, PhD
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Dennis Den Hartog, MD, PhD
- Corresponding author: Dennis Den Hartog, MD, PhD, Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.; Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Ivo Beetz, MD, PhD
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Hugo W. Bolhuis, MD
- Department of Surgery, Gelre Hospital, Apeldoorn, The Netherlands
- P. Koen Bos, MD, PhD
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Maarten W.G.A. Bronkhorst, MD, PhD
- Trauma Unit, Haaglanden MC, The Hague, The Netherlands
- Milko M.M. Bruijninckx, MD
- Department of Surgery, IJsselland Hospital, Capelle a/d Ijssel, The Netherlands
- Jeroen De Haan, MD, PhD
- Department of Surgery, Dijklander Ziekenhuis, Hoorn, The Netherlands
- Axel R. Deenik, MD, PhD
- Department of Orthopaedic Surgery, Haaglanden MC, The Hague, The Netherlands
- P. Ted Den Hoed, MD, PhD
- Department of Surgery, Ikazia Hospital, Rotterdam, The Netherlands
- Martin G. Eversdijk, MD
- Department of Surgery, St. Jansdal Hospital, Harderwijk, The Netherlands
- J. Carel Goslings, MD, PhD
- Trauma Unit, Department of Surgery, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
- Robert Haverlag, MD
- Department of Surgery, OLVG, Amsterdam, The Netherlands
- Martin J. Heetveld, MD, PhD
- Department of Surgery, Spaarne Gasthuis, Haarlem, The Netherlands
- Albertus J.H. Kerver, MD, PhD
- Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
- Karel A. Kolkman, MD
- Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands
- Peter A. Leenhouts, MD, MBA
- Department of Surgery, Zaans Medical Center, Zaandam, The Netherlands
- Kiran C. Mahabier, MD, PhD
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Sven A.G. Meylaerts, MD, PhD
- Trauma Unit, Haaglanden MC, The Hague, The Netherlands
- Ron Onstenk, MD
- Department of Orthopaedic Surgery, Groene Hart Hospital, Gouda, The Netherlands
- Martijn Poeze, MD, PhD
- Department of Trauma Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- Rudolf W. Poolman, MD, PhD
- Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands
- Bas J. Punt, MD
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
- Ewan D. Ritchie, MD
- Department of Surgery, Alrijne Hospital, Leiderdorp, The Netherlands
- W. Herbert Roerdink, MD, PhD
- Department of Surgery, Deventer Hospital, Deventer, The Netherlands
- Gert R. Roukema, MD
- Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands
- Jan Bernard Sintenie, MD
- Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands
- Nicolaj M.R. Soesman, MD
- Department of Surgery, Franciscus Gasthuis & Vlietland, Schiedam, The Netherlands
- Edgar J.T. Ten Holder, MD
- Department of Orthopaedic Surgery, IJsselland Hospital, Capelle a/d IJssel, The Netherlands
- Wim E. Tuinebreijer, MD, PhD
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Maarten Van der Elst, MD, PhD
- Department of Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands
- Frank H.W.M. Van der Heijden, MD, PhD
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
- Frits M. Van der Linden, MD
- Department of Surgery, Groene Hart Hospital, Gouda, The Netherlands
- Peer Van der Zwaal, MD, PhD
- Trauma Unit, Haaglanden MC, The Hague, The Netherlands
- Jan P. Van Dijk, MD
- Department of Surgery, Hospital Gelderse Vallei, Ede, The Netherlands
- Hans-Peter W. Van Jonbergen, MD, PhD
- Department of Orthopaedic Surgery, Deventer Hospital, Deventer, The Netherlands
- Egbert J.M.M. Verleisdonk, MD, PhD
- Department of Surgery, Diakonessenhuis, Utrecht, The Netherlands
- Jos P.A.M. Vroemen, MD, PhD
- Department of Surgery, Amphia Hospital, Breda, The Netherlands
- Marco Waleboer, MD
- Department of Surgery, Admiraal De Ruyter Hospital, Goes, The Netherlands
- Philippe Wittich, MD, PhD
- Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
- Wietse P. Zuidema, MD
- Department of Trauma Surgery, Amsterdam University Medical Center, location VUmc, Amsterdam, The Netherlands
- Journal volume & issue
-
Vol. 7,
no. 3
pp. 516 – 522
Abstract
Background: The consequences of radial nerve palsy associated with a humeral shaft fracture are unclear. The aim of this study was to examine the functional recovery of radial nerve palsy, at presentation or postoperatively, in patients with a humeral shaft fracture. Methods: Data from patients who participated in the HUMeral shaft fractures: measuring recovery after operative versus non-operative treatment (HUMMER) study, a multicenter prospective cohort study including adults with a closed humeral shaft fracture Arbeitsgemeinschaft für Osteosynthesefragen (AO) type 12A or 12B, and had radial nerve palsy at presentation or postoperatively, were extracted from the HUMMER database. The primary outcome measure was clinically assessed recovery of motor function of the radial nerve. Secondary outcomes consisted of treatment, functional outcome (Disabilities of the Arm, Shoulder, and Hand and Constant–Murley Score), pain level, quality of life (Short Form-36 and EuroQoL-5D-3L), activity resumption, and range of motion of the shoulder and elbow joint at 12 months after trauma. Results: Three of the 145 nonoperatively treated patients had radial nerve palsy at presentation. One recovered spontaneously and 1 after osteosynthesis. Despite multiple surgical interventions, the third patient had no recovery after entrapment between fracture fragments. Thirteen of the 245 operatively treated patients had radial nerve palsy at presentation; all recovered. Nine other patients had postoperative radial nerve palsy; 8 recovered. One had ongoing recovery at the last follow-up, after nerve release and suture repair due to entrapment under the plate. At 12 months, the functional outcome scores of all patients suggested full recovery regarding functional outcome, pain, quality of life, activity resumption, and range of motion. Conclusion: Radial nerve palsy in patients with a humeral shaft fracture at presentation or postoperatively functionally recovers in 94% and 89%, respectively.
