ISSN 2458-7834
 

Original Article 


Radial nerve grafting in high energy humeral fractures

Yusuf Gürbüz, Tahir Sadık Sügün, Kemal Özaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan.

Cited By: 1

Abstract
Objectives: The functional recovery after reconstruction of radial nerve injuries associated with high energy humerus fractures is generally poor. The purpose of this study is to evaluate the functional and clinical outcomes of intermediate-level radial nerve injuries due to high energy humeral fractures, treated with sural nerve grafting.
Methods: From 1994 to 2010, eleven patients (8 male, 3 female mean age: 33.1) with high energy humerus fractures associated at radial nerve palsy were treated with sural nerve grafting besides fracture fixation. Etiologies were traffic accidents in 7 patients and work-related accidents in 4 patients. The length of radial nerve gap was 10 cm in six patients, 9 cm in one patients, 8 cm in three patients and 4 cm in one patient The mean time interval between injury and the surgical intervention was 108.1 (range: 0-330) days. The functional results were evaluated according to system of Verga. Clinical results were assessed by, grip and pinch strengths.
Results: The mean time for beginning to demonstrate initial contractions of the radial wrist extensors at was 10.7 months. The mean time to follow-up from deliver to study was 68.6 months. The individual muscle power according to Verga scoring system was excellent in 6, good in 1, fair in 2 and poor in 2 patients. All patients achieved a mean grip strength 58% of unaffected hands and a mean maximum key pinch strength was achieved 67% of unaffected hands. All fractures were healed.
Conclusion: Prolonged external fixation and extensive crush arm injuries can decrease the success of nerve healing. Excluding these conditions, good functional results may be obtained with nerve grafts longer than eight cm associated with high energy humeral fractures.

Key words: Humerus fracture, radial nerve graft


 
ARTICLE TOOLS
Abstract
PDF Fulltext
How to cite this articleHow to cite this article
Citation Tools
Related Records
 Articles by Yusuf Gürbüz
Articles by Tahir Sadık Sügün
Articles by Kemal Özaksar
Articles by Murat Kayalar
Articles by Tulgar Toros
Articles by İbrahim Kaplan
on Google
on Google Scholar


REFERENCES
1. Bleeker WA, Nijsten MW, ten Duis HJ. Treatment of humeralshaft fractures related to associated injuries. A retrospectivestudy of 237 patients. Acta Orthop Scand 1991;62:148-53. [DOI via Crossref]    [Pubmed]   
2. Lowe JB 3rd, Sen SK, Mackinnon SE. Current approach to radialnerve paralysis. Plast Reconstr Surg 2002;110:1099-113. [DOI via Crossref]   
3. Shao AS, Harwood P, Grotz MR, Limb D, Giannoudis PV.Radial nerve palsy associated with fractures of the shaft of thehumerus: a systematic review. J Bone Joint Surg Br 2005;87:1647-52. [DOI via Crossref]    [Pubmed]   
4. Ring D, Chin K, Jupiter JB. Radial nerve palsy associated withhigh-energy humeral shaft fractures. J Hand Surg Am2004;29:144-7.
5. Meek MF, Coert JH, Robinson PH. Poor results after nervegrafting in the upper extremity: quo vadis? Microsurgery 2005;25:396-402.
6. Shergill G, Bonney G, Munshi P, Birch R. The radial and posteriorinterosseous nerves. Results of 260 repairs. J Bone JointSurg Br 2001;83:646-9. [DOI via Crossref]   
7. Pan CH, Chuang DC, Rodri´guez-Lorenzo A. Outcomes ofnerve reconstruction for radial nerve injuries based on the levelof injury in 244 operative cases. J Hand Surg Eur 2010;35:385-91. [DOI via Crossref]    [Pubmed]   
8. Gustilo B, Anderson JP. Prevention of infection in the treatmentof one-thousend and twenty-five fractures of long bones. J BoneJoint Surg Am 1976;58:453-60.
9. Fisher TR, McGeoch CM. Severe injuries of the radial nervetreated by sural nerve grafting. Injury 1981;16:411-2.
10. Moneim M. Interfascicular nerve grafting. Clin Orthop RelatRes 1982;(163):65-74.
11. Brunelli G, Monini L, Brunelli F. Problems in nerve lesions.Microsurgery 1985;6:187-98. [DOI via Crossref]    [Pubmed]   
12. Omer GE. Acute management of peripheral nerve injuries.Hand Clin 1986;1:193-206.
13. Medical Research Council. Aids to examination of the peripheralnervous system. Memorandum No.45. London, HMSO;1976.
14. Verga M, Peri Di Caprio A, Bocchiotti MA, Battistella F.,Bruschi S, Petrolati M. Delayed treatment of persistent radialnerve paralysis associated with fractures of the middle third ofhumerus: review and evaluation of the long-term results of 52cases. J Hand Surg Eur Vol 2007;32:529-33. [DOI via Crossref]    [Pubmed]   
15. Colditz J. Splinting for radial nerve palsy. J Hand Ther1987;1:18-23.
16. Foster RJ, Swiontkowski MF, Bach AW, Sack JT. Radial nervepalsy caused by open humeral shaft fractures. J Hand Surg Am1993;18:121-4.
17. Venouziou AI, Dailiana ZH, Varitimidis SE, Hantes ME,Gougoulias NE, Malizos KN. Radial nerve palsy associated withhumeral shaft fracture. Is the energy of trauma a prognostic factor?Injury 2011;42:1289-93.
18. Henry M. Wide resection of traction induced radial nerve injurywith cable grafting leads to full recovery. Hand (NY) 2006;1:85-8. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
19. Millesi H, Meissl G, Berger A. Further experience with interfasciculargrafting of the median, ulnar, and radial nerves. J BoneJoint Surg Am 1976;58:209-18.
20. Murovic JA. Upper-extremity peripheral nerve injuries: aLouisiana State University Health Sciences Center literaturereview with comparison of the operative outcomes of 1837Louisiana State University Health Sciences Center median, radial,and ulnar nerve lesions. Neurosurgery 2009;65:11-7. [DOI via Crossref]    [Pubmed]   
21. Nunley JA, Sa›es AD, Sandow MJ, Urbaniak JR. Results of interfascicularnerve grafting for radial nerve lesions. Microsurgery1996;17:431-7.
22. Lee YH, Chung MS, Gong HS, Chung JY, Park JH, Baek GH.Sural nerve autografts for high radial nerve injury with nine centimeteror greater defects. J Hand Surg Am 2008;33:83-6. [DOI via Crossref]    [Pubmed]   

This Article Cited By the following articles

A successful double-layer facial nerve repair: A case presentation
Hand and Microsurgery 2015; (): 1.

1
 
How to Cite this Article
Pubmed Style

Yusuf Gurbuz, Tahir Sadık Sugun, Kemal Ozaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan. Radial nerve grafting in high energy humeral fractures. Hand Microsurg. 2012; 1(2): 60-64. doi:10.2399/emd.12.58077


Web Style

Yusuf Gurbuz, Tahir Sadık Sugun, Kemal Ozaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan. Radial nerve grafting in high energy humeral fractures. https://handmicrosurgeryjournal.com/?mno=163381 [Access: May 16, 2023]. doi:10.2399/emd.12.58077


AMA (American Medical Association) Style

Yusuf Gurbuz, Tahir Sadık Sugun, Kemal Ozaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan. Radial nerve grafting in high energy humeral fractures. Hand Microsurg. 2012; 1(2): 60-64. doi:10.2399/emd.12.58077



Vancouver/ICMJE Style

Yusuf Gurbuz, Tahir Sadık Sugun, Kemal Ozaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan. Radial nerve grafting in high energy humeral fractures. Hand Microsurg. (2012), [cited May 16, 2023]; 1(2): 60-64. doi:10.2399/emd.12.58077



Harvard Style

Yusuf Gurbuz, Tahir Sadık Sugun, Kemal Ozaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan (2012) Radial nerve grafting in high energy humeral fractures. Hand Microsurg, 1 (2), 60-64. doi:10.2399/emd.12.58077



Turabian Style

Yusuf Gurbuz, Tahir Sadık Sugun, Kemal Ozaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan. 2012. Radial nerve grafting in high energy humeral fractures. Hand and Microsurgery, 1 (2), 60-64. doi:10.2399/emd.12.58077



Chicago Style

Yusuf Gurbuz, Tahir Sadık Sugun, Kemal Ozaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan. "Radial nerve grafting in high energy humeral fractures." Hand and Microsurgery 1 (2012), 60-64. doi:10.2399/emd.12.58077



MLA (The Modern Language Association) Style

Yusuf Gurbuz, Tahir Sadık Sugun, Kemal Ozaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan. "Radial nerve grafting in high energy humeral fractures." Hand and Microsurgery 1.2 (2012), 60-64. Print. doi:10.2399/emd.12.58077



APA (American Psychological Association) Style

Yusuf Gurbuz, Tahir Sadık Sugun, Kemal Ozaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan (2012) Radial nerve grafting in high energy humeral fractures. Hand and Microsurgery, 1 (2), 60-64. doi:10.2399/emd.12.58077





Most Viewed Articles
  • Giant intramuscular lipoma of arm: A case report and review of the literature
    Muzaffer Durmus, Ahmet Demirhan Dal, Abdul Kerim Yapici, Sedat Avsar, Yalcin Bayram
    Hand Microsurg. 2014; 3(3): 87-90
    » Abstract & References » doi: 10.5455/handmicrosurg.173820

  • Cubital tunnel syndrome due to heterotrophic ossification caused by radial head fracture: A case report
    Seyitali Gumustas, Haci Bayram Tosun, Ismail Agir, Abuzer Uludag
    Hand Microsurg. 2014; 3(1): 24-28
    » Abstract & References » doi: 10.5455/handmicrosurg.1577

  • MunchausenÂ’s syndrome or pure self-mutilation? A case of self-inflicted tendon injury
    Burak Kaya, Servet Elcin Alpat, Mehmet Sonmez, Cem Cerkez, Savas Serel
    Hand Microsurg. 2014; 3(3): 83-86
    » Abstract & References » doi: 10.5455/handmicrosurg.172607

  • Radial nerve grafting in high energy humeral fractures
    Yusuf Gürbüz, Tahir Sadık Sügün, Kemal Özaksar, Murat Kayalar, Tulgar Toros, İbrahim Kaplan
    Hand Microsurg. 2012; 1(2): 60-64
    » Abstract & References » doi: 10.2399/emd.12.58077

  • The utility of onion extract gel containing topical allantoin and heparin after surgical treatment of upper extremity burn scars
    Mehmet Ihsan Okur, Alpagan Mustafa Yildirim, Bilsev Ince
    Hand Microsurg. 2014; 3(3): 74-79
    » Abstract & References » doi: 10.5455/handmicrosurg.172436

  • Most Downloaded
  • Bone island and hand involvement – A short review
    Ganesh Singh Dharmshaktu, Binit Singh
    Hand Microsurg. 2018; 7(2): 93-97
    » Abstract » doi: 10.5455/handmicrosurg.258665

  • Lipofibromatous hamartoma of the digital nerve: A case report
    Emin Sir, Alper Aksoy
    Hand Microsurg. 2018; 7(1): 45-48
    » Abstract » doi: 10.5455/handmicrosurg.255406

  • Love signÂ’s love for glomus tumor
    Ankit Shukla, Varun Verma, Roshni Shukla, Rajesh Chaudhary, Saurab Sharma, Sajid Mohammad
    Hand Microsurg. 2018; 7(2): 105-108
    » Abstract » doi: 10.5455/handmicrosurg.279749

  • The three bony point relationship of the elbow-Why is there still a lack of consensus?
    Supreeth Nekkanti, Dama Kondaiah Naidu, Jasmine Sebastin, Kamal Prasad, Mohan Yeshwanth, Archana Meka
    Hand Microsurg. 2018; 7(2): 79-82
    » Abstract » doi: 10.5455/handmicrosurg.291476

  • Hand grip strength: Age and gender stratified normative data in Anatolian population
    Melih Unal, Ozkan Kose, Hasan Onur Arik, Ferhat Guler, Baver Acar, Halil Yalcin Yuksel
    Hand Microsurg. 2018; 7(1): 16-23
    » Abstract » doi: 10.5455/handmicrosurg.257058

  • Most Cited Articles
  • The rise of wide awake hand surgery - Contribution from Turkey
    Egemen Ayhan, Emre Ozdemir, Ender Gumusoglu, Kadir Cevik, Metin M Eskandari
    Hand Microsurg. 2018; 7(3): 125-134
    » Abstract » doi: 10.5455/handmicrosurg.299709
    Cited : 7 times [Click to see citing articles]

  • Giant lipomas of the hand
    Gokce Yildiran, Osman Akdag, Mehtap Karamese, Muhammed Nebil Selimoglu, Zekeriya Tosun
    Hand Microsurg. 2015; 4(1): 8-11
    » Abstract & References » doi: 10.5455/handmicrosurg.175443
    Cited : 4 times [Click to see citing articles]

  • Hand grip strength: Age and gender stratified normative data in Anatolian population
    Melih Unal, Ozkan Kose, Hasan Onur Arik, Ferhat Guler, Baver Acar, Halil Yalcin Yuksel
    Hand Microsurg. 2018; 7(1): 16-23
    » Abstract » doi: 10.5455/handmicrosurg.257058
    Cited : 3 times [Click to see citing articles]

  • Upper extremity tumors
    Levent Eralp , Halil Buldu
    Hand Microsurg. 2013; 2(3): 105-114
    » Abstract & References » doi: 10.5455/handmicrosurg.164446
    Cited : 3 times [Click to see citing articles]

  • Flexor pollicis longus repair in a patient with Linburg-Comstock anomaly: A case report
    Mehmet Unal, Eren Cansu, Hakan Cift
    Hand Microsurg. 2016; 5(2): 88-91
    » Abstract » doi: 10.5455/handmicrosurg.193633
    Cited : 3 times [Click to see citing articles]