{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:22:34Z","timestamp":1784697754769,"version":"3.55.0"},"reference-count":27,"publisher":"MDPI AG","issue":"11","license":[{"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\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Due to the rarity of radial nerve palsy in humeral shaft fractures in the paediatric population and the lack of data in the literature, the purpose of our study was to report the treatment results of six children who sustained a radial nerve injury following a humeral shaft fracture. Materials and Methods: We treated six paediatric patients with radial nerve palsy caused by a humeral shaft fracture in our department from January 2011 to June 2022. The study group consisted of four boys and one girl aged 8.6 to 17.2 (average 13.6). The mean follow-up was 18.4 months. To present our results, we have used the STROBE protocol designed for retrospective observational studies. Results: We diagnosed two open and four closed humeral shaft fractures. Two simple transverse AO 12A3c; one simple oblique AO 12A2c; two simple spiral AO 12A1b\/AO 12A1c and one intact wedge AO 12B2c were recognized. The humeral shaft was affected in the distal third five times and in the middle third one time. In our study group, we found two cases of neurotmesis; two entrapped nerves within the fracture; one stretched nerve over the bone fragments and one case of neuropraxia. We found restitution of the motor function in all cases. For all patients, extensor muscle strength was assessed on the grade M4 according to the BMRC scale (except for a patient with neuropraxia\u2014M5). The differences in patients concerned the incomplete extension at the radiocarpal and metacarpophalangeal (MCP) joints. Conclusions: In our small case series, humeral shaft fractures complicated with radial nerve palsy are always challenging medical issues. In paediatric patients, we highly recommend an US examination where it is possible to be carried out to improve the system of decision making. Expectant observation with no nerve exploration is reasonable only in close fractures caused by low-energy trauma. Early surgical nerve exploration related with fracture stabilisation is highly recommended in fractures after high-energy trauma, especially in open fractures and where symptoms of nerve palsy appear at any stage of conservative treatment.<\/jats:p>","DOI":"10.3390\/medicina58111571","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T06:01:28Z","timestamp":1667282488000},"page":"1571","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Treatment of Radial Nerve Palsy in Paediatric Humeral Shaft Fractures\u2014STROBE-Compliant Investigation"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5777-3835","authenticated-orcid":false,"given":"\u0141ukasz","family":"Wiktor","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, Upper Silesian Children\u2019s Health Centre, 40-752 Katowice, Poland"},{"name":"Department of Trauma and Orthopedic Surgery, ZSM Hospital, 41-500 Chorz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1628-0866","authenticated-orcid":false,"given":"Ryszard","family":"Tomaszewski","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, Upper Silesian Children\u2019s Health Centre, 40-752 Katowice, Poland"},{"name":"Institute of Biomedical Engineering, Faculty of Science and Technology, University of Silesia in Katowice, 40-007 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/01.blo.0000156452.91271.fb","article-title":"Pediatric fractures of the humerus","volume":"432","author":"Caviglia","year":"2005","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/j.injury.2007.01.036","article-title":"The epidemiology of fractures in children","volume":"38","author":"Rennie","year":"2007","journal-title":"Injury"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s11832-014-0577-0","article-title":"Paediatric supracondylar humeral fractures: Epidemiology, mechanisms and incidence during school holidays","volume":"8","author":"Barr","year":"2014","journal-title":"J. Child Orthop."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/S0363-5023(97)80157-8","article-title":"Anatomy of the radial nerve motor branches in the forearm","volume":"22","author":"Abrams","year":"1997","journal-title":"J. Hand Surg. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1302\/2058-5241.1.000028","article-title":"Radial nerve palsy","volume":"1","author":"Bumbasirevic","year":"2017","journal-title":"EFORT Open Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1302\/0301-620X.87B12.16132","article-title":"Radial nerve palsy associated with fractures of the shaft of the humerus: A systematic review","volume":"87-B","author":"Shao","year":"2005","journal-title":"J. Bone Joint Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"239","DOI":"10.2106\/00004623-198163020-00009","article-title":"Treatment of radial neuropathy associated with fractures of the humerus","volume":"63-A","author":"Pollock","year":"1981","journal-title":"J. Bone Joint Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1080\/028443100750059156","article-title":"Radial nerve palsy after simple fracture of the humerus","volume":"34","author":"Larsen","year":"2000","journal-title":"Scand. J. Plast. Reconstr. Surg. Hand Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1097\/00005131-200003000-00002","article-title":"Randomized prospective study of humeral shaft fracture fixation: Intramedulllary nails versus plates","volume":"14","author":"Chapman","year":"2000","journal-title":"J. Orthop. Trauma."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s00402-009-0951-4","article-title":"The management of humera\u0142 shaft fractures with associated radial nerve palsy: A review of 117 cases","volume":"130","author":"Atkinson","year":"2010","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"Altman","year":"2007","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2838","DOI":"10.1093\/brain\/awq270","article-title":"Aids to the investigation of peripheral nerve injuries","volume":"133","author":"Compston","year":"2010","journal-title":"Brain"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1302\/1863-2548.13.190012","article-title":"Management of paediatric humeral shaft fractures and associated nerve palsy","volume":"13","author":"Parry","year":"2019","journal-title":"J. Child Orthop."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.ejrad.2008.10.038","article-title":"Ultrasonographic evaluation of the iatrogenic peripheral nerve injuries in upper extremity","volume":"73","author":"Karabay","year":"2010","journal-title":"Eur. J. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"415","DOI":"10.2214\/ajr.177.2.1770415","article-title":"Examination of postoperative peripheral nerve lesions with high-resolution sonography","volume":"177","author":"Peer","year":"2001","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.jhsa.2006.02.013","article-title":"Radial nerve injuries associated with humeral fractures","volume":"31","author":"DeFranco","year":"2006","journal-title":"J. Hand Surg. Am."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1590\/1413-78522015230100823","article-title":"Radial nerve injury associated with humeral shaft fracture: A retrospective study","volume":"23","author":"Ricci","year":"2015","journal-title":"Acta. Ortop. Bras."},{"key":"ref_18","first-page":"173","article-title":"Nerve repair and grafting in the upper extremity","volume":"10","author":"Payne","year":"2001","journal-title":"J. South Orthop. Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1002\/(SICI)1097-4598(200006)23:6<863::AID-MUS4>3.0.CO;2-0","article-title":"Traumatic injury to peripheral nerves","volume":"23","author":"Robinson","year":"2000","journal-title":"Muscle Nerve"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1016\/j.jhsa.2018.04.018","article-title":"Outcomes of Radial Nerve Grafting In Children after Distal Humerus Fracture","volume":"43","author":"Bertelli","year":"2018","journal-title":"J. Hand Surg. Am."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1148\/radiology.219.3.r01jn09811","article-title":"Radial nerve palsy associated with humeral shaft fracture: Evaluation with USA\u2014Initial experience","volume":"219","author":"Bodner","year":"2001","journal-title":"Radiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.2106\/00004623-196345070-00004","article-title":"Fractures of the humerus with radial nerve paralysis","volume":"45","author":"Holstein","year":"1963","journal-title":"J. Bone Jt. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/BOT.0b013e318177eb06","article-title":"Primary radial nerve palsy in patients with acute humeral shaft fractures","volume":"22","author":"Ekholm","year":"2008","journal-title":"J. Orthop. Trauma."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e263","DOI":"10.5435\/JAAOS-D-18-00142","article-title":"Radial Nerve Palsy Recovery with Fractures of the Humerus: An Updated Systematic Review","volume":"28","author":"Ilyas","year":"2020","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"573","DOI":"10.3171\/jns.2001.95.4.0573","article-title":"Surgical management and outcome in patients with radial nerve lesions","volume":"95","author":"Kim","year":"2001","journal-title":"J. Neurosurg."},{"key":"ref_26","first-page":"1099","article-title":"Current approach to radial nerve paralysis","volume":"110","author":"Lowe","year":"2002","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.injury.2013.01.004","article-title":"Approach to radial nerve palsy caused by humerus shaft fracture: Is primary exploration necessary?","volume":"44","author":"Korompilias","year":"2013","journal-title":"Injury"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/11\/1571\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:07:04Z","timestamp":1760144824000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/11\/1571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,31]]},"references-count":27,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["medicina58111571"],"URL":"https:\/\/doi.org\/10.3390\/medicina58111571","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,31]]}}}