{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T02:11:49Z","timestamp":1787969509618,"version":"build-2784847793"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Intramedullary humeral nailing is a common and reliable procedure for the treatment of humeral shaft fractures. Radial nerve palsy is a common complication encountered in the treatment of this pathology. The radial nerve runs from posterior to anterior at the lateral aspect of the distal humerus. Hence, there is reason to believe that due to the anatomic vicinity of the radial nerve in this area, lateral\u2013medial distal locking in intramedullary nailing of the humerus may be associated with a greater risk for iatrogenic radial nerve injury compared to anterior\u2013posterior locking.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Questions\/purpose<\/jats:title>\n                <jats:p>To assess whether the choice of distal locking (lateral\u2013medial versus anterior\u2013posterior distal locking) in intramedullary humeral nailing of humeral shaft fractures affects the risk for iatrogenic radial nerve injury.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Patients and methods<\/jats:title>\n                <jats:p>Overall, 203 patients (116 females, mean age 64.3\u2009\u00b1\u200918.6\u00a0years), who underwent intramedullary nailing of the humerus between 2000 and 2020 at a single level-one trauma center, met the inclusion criteria and were analyzed in this retrospective case\u2013control study. Patients were subdivided into two groups according to the distal locking technique.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Anterior\u2013posterior locking was performed in 176 patients versus lateral\u2013medial locking in 27 patients. We observed four patients with iatrogenic radial nerve palsy in both groups. Risk for iatrogenic radial nerve palsy was almost 7.5 times higher for lateral\u2013medial locking (OR 7.48, <jats:italic>p<\/jats:italic>\u2009=\u20090.006). There was no statistically significant difference regarding intraoperative complications, union rates or revision surgeries between both groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Lateral\u2013medial distal locking in intramedullary nailing of the humerus may be associated with a greater risk for iatrogenic radial nerve palsy than anterior\u2013posterior locking. Hence, we advocate for anterior\u2013posterior locking.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of evidence<\/jats:title>\n                <jats:p>Level III retrospective comparative study.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00402-022-04665-1","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T20:03:00Z","timestamp":1667246580000},"page":"4117-4123","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Distal locking technique affects the rate of iatrogenic radial nerve palsy in intramedullary nailing of humeral shaft fractures"],"prefix":"10.1007","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-4930","authenticated-orcid":false,"given":"Fabian","family":"Greiner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Kaiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Kleiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Brugger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Aldrian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Windhager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Hajdu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Schreiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"issue":"9","key":"4665_CR1","doi-asserted-by":"publisher","first-page":"2638","DOI":"10.1007\/s11999-011-1791-4","volume":"469","author":"S Arora","year":"2011","unstructured":"Arora S, Goel N, Cheema GS, Batra S, Maini L (2011) A method to localize the radial nerve using the \u2018Apex Of Triceps Aponeurosis\u2019 as a landmark. 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Author RW has received speaker and consultant honoraria from Johnson & Johnson, Stryker and DePuy Synthes. Author RW served as an advisor for product development for DePuy Synthes.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the local ethic committee and was performed in accordance with the Declaration of Helsinki for ethical principles for medical research involving human subjects.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Review Committee"}},{"value":"Patient consent was waived due to the minimal risk of this retrospective study. Moreover, this research did not adversely affect the rights and welfare of the investigated subjects. All the procedures being performed were part of the routine care. All data were handled anonymously, and no subjects identity is revealed in this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}