DOS 2018

DOS Kongressen 2018 · 269 Secondary Radial Neuropathy In Conjunction With Closed Intramedullary Nailing Of Humeral Shaft Fractures – Results Over A 10-Year Period Michelle Fog Andersen, Anton Mitchell Ulstrup Department of Orthopaedic Surgery, Holbæk Hospital Background: A satisfying functional result in the treatment of adult humeral shaft fractures with locked intramedullary nailing entails preserved function of the radial nerve. It is found worth investigating the risk of radial nerve injury when a long nail is introduced into a humeral shaft fracture without surgical radial nerve exploration. Purpose / Aim of Study: To retrospectively examine the outcome of intra- operative radial nerve lesions following humeral shaft fixation with locked long intramedullary nailing without nerve exploration. Materials and Methods: Between 2007 and 2016, 89 patients with no pre- operative nerve lesion were treated for a displaced humeral shaft fracture with a locked long intramedullary nail performed in five centres in Region Zealand. All motoric radial nerve lesions were registered and followed up in medical records until treatment of the patient ended. Findings / Results: 85 out of 89 patients (mean age; 67 years) were available for an outpatient follow-up. 72 fractures were non-pathological and of these, 31 were nonunions. 28 and 61 were identified in the proximal and middle thirds of the humeral shaft. In total, 9% (8/89) developed immediate postoperative radial nerve palsies. The risk of a radial nerve palsy was 7.9% (6/76) for closed nailing and 15.4% (2/13) for nailing involving open surgery in the fracture area. Of these, the risk was 33% (2/6) for nailing with a nerve exploration. 1 pa- tient sustained a verifiable permanent radial nerve paralysis. Associations of a postoperative radial nerve palsy were mid-shaft fractures, female gender and surgery for nonunion fractures. Conclusions: Our results indicate that exploration of the radial nerve is not necessary routinely in order to prevent radial nerve lesions when performing closed nailing for humeral shaft fractures in adults with a preoperative normal radial nerve function. 210.