Trans-fracture transposition of the radial nerve during the open approach of humeral shaft fractures

• Published in: European journal of orthopaedic surgery & traumatology Vol. 23; no. 6; pp. 725 - 730
• Main Authors: Chamseddine, Ali H., Zein, Hadi K., Alasiry, Abdullah A., Mansour, Nader A., Bazzal, Ali M.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01-08-2013; Springer Nature B.V
• Subjects: Adult; Aged; Female; Follow-Up Studies; Fracture Fixation, Internal - methods; Humans; Humeral Fractures - surgery; Humerus - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Radial Nerve - transplantation; Surgical Orthopedics; Technical Note; Traumatic Surgery; Treatment Outcome; Open reduction of humeral fracture; Radial nerve; Radial nerve transposition; Humeral shaft fracture
• ISSN: 1633-8065; 1432-1068
• DOI: 10.1007/s00590-012-1065-1

The radial nerve constitutes a major problem in humeral shaft fractures; it may be injured immediately or during closed reduction or open reduction and internal fixation with plate and screws. After fixation, the nerve always runs directly over the plate without any interposed structure. If a revision surgery is indicated, the nerve is at high risk as it is usually difficult to dissect from surrounding fibrotic scar tissue or callus formation. To avoid these complications, some authors reported transposition of the radial nerve through the fracture line. We present herein the surgical technique of the trans-fracture transposition of the radial nerve during open reduction and internal fixation of humeral shaft fractures, along with our preliminary results in 6 cases and a review of the literature.