[Humeral fractures complicated by radial nerve lesions]

In the period of 1966-1975 the authors treated 228 patients with a fractures of diaphysis of humerus, 103 of whom underwent surgery; in 36 of them a paralysis of the radial nerve occurred. These 36 patients were divided into two groups: primary lesions (22 cases) which were discovered during hospitalization, and secondary lesions which occurred in postoperative course. The aim of clinical research with the primary lesion (respectively 22 patients) was to ascertain which method would have the best effect. In 77,2% of these patients, a radial nerve was not interrupted, while in 13.6% its continuity was partially preserved, and only in 9.09% a complete interruption occurred. Complete recovery of the nerve was in 50% of patients, 22.7% had a small conduction deficit, while its paralysis was further present in 18.8% of cases. Accordingly to this, the authors attained an excellent and very good results in 59% of patients, while in the remaining 41% of cases the results was satisfactory. It has been established that primary lesions of radial nerve has been occurring in 7.64% of cases (similar date do exist in reviewed reports), and in the majority of patients a spontaneously recovery will occur in the course of 2-3 months. Therefore the authors are not for a primary exploration of n.radialis if it is a question of closed fractures. In rare cases with interruption of the radial nerve with extensive contusions of both simultaneously interrupted nervous stumps a primary suture is not indicated. Therefore an eventual surgical exploration to establish whether an interruption of the nerve exists, does not contribute to attain recovery.