{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T01:47:11Z","timestamp":1792547231888,"version":"4.5.0"},"reference-count":22,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"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: Radial nerve palsy is one of the most clinically important neurological complications associated with humeral shaft fractures. This study aimed to evaluate the incidence of radial nerve palsy in adult humeral shaft fractures and to investigate recovery patterns and functional outcomes in surgically treated patients. Materials and Methods: This single-center retrospective observational study included adult patients with humeral shaft fractures treated between November 2022 and January 2025. All adult humeral shaft fractures during the study period were screened to determine the overall rate of radial nerve palsy. The final functional analysis included surgically treated patients with radial nerve palsy. Demographic data, fracture characteristics, injury energy, fracture type, timing of radial nerve palsy, treatment modality, operative time, radial nerve exploration, additional surgery, time to nerve recovery, and QuickDASH scores were evaluated. Conservatively managed patients with radial nerve palsy were included in the calculation of overall incidence and recovery rates but were not included in the final functional analyses. Results: A total of 469 adult patients with humeral shaft fractures were evaluated. Radial nerve palsy was identified in 77 patients, corresponding to an overall rate of 16.4%. The rate was 46.4% in open fractures and 14.5% in closed fractures. Among the 77 patients with radial nerve palsy, 49 underwent surgical treatment and constituted the final analysis cohort, whereas 28 were managed conservatively. Recovery was observed in 25 of 28 conservatively managed patients (89.3%) and in 35 of 49 surgically treated patients (71.4%). Overall, radial nerve function recovered in 60 of 77 patients (77.9%). New-onset postoperative radial nerve palsy developed in 29 of 129 surgically treated patients without preoperative palsy (22.5%); however, recovery occurred in 22 of these 29 patients (75.9%), and the rate of persistent postoperative palsy was 5.4% among patients without preoperative palsy. In the surgical cohort, open fracture, longer operative time, and higher initial Cobb angle were associated with non-recovery. Recovery of radial nerve function was the only factor independently associated with better QuickDASH scores. Conclusions: Radial nerve palsy was more frequent in open humeral shaft fractures. Although recovery was high among conservatively managed patients, surgically treated cases showed a lower recovery rate, likely reflecting greater injury complexity. New-onset postoperative radial nerve palsy was relatively frequent, but most cases recovered. Recovery of radial nerve function was strongly associated with better upper extremity functional outcomes.<\/jats:p>","DOI":"10.3390\/medicina62071427","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T13:25:46Z","timestamp":1784726746000},"page":"1427","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Radial Nerve Palsy Associated with Humeral Shaft Fractures: Incidence, Recovery Patterns, and Functional Outcomes in Surgically Treated Patients"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8378-4346","authenticated-orcid":false,"given":"Ahmet","family":"Acar","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Etlik City Hospital, 06170 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3293-8231","authenticated-orcid":false,"given":"Ahmet Berkay","family":"Girgin","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Akyurt State Hospital, 06750 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2042-230X","authenticated-orcid":false,"given":"Ay\u015fe Bet\u00fcl","family":"Acar","sequence":"additional","affiliation":[{"name":"Department of Algology and Pain Medicine, Etlik City Hospital, 06170 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6155-8329","authenticated-orcid":false,"given":"Muhammed Faz\u0131l","family":"\u00d6zcan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Etlik City Hospital, 06170 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5787-3908","authenticated-orcid":false,"given":"\u00d6mer","family":"Torun","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Etlik City Hospital, 06170 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1302\/2058-5241.6.200033","article-title":"Humeral shaft fractures","volume":"6","author":"Gallusser","year":"2021","journal-title":"EFORT Open Rev."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Theeuwes, H.P., Van Der Ende, B., Potters, J.W., Kerver, A.J., Bessems, J.H.J.M., and Kleinrensink, G.-J. (2017). The course of the radial nerve in the distal humerus: A novel, anatomy based, radiographic assessment. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0186890"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/s00068-017-0775-9","article-title":"Radial nerve palsy in humeral shaft fractures with internal fixation: Analysis of management and outcome","volume":"44","author":"Schwab","year":"2018","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1302\/2058-5241.1.000028","article-title":"Radial nerve palsy","volume":"1","author":"Bumbasirevic","year":"2016","journal-title":"EFORT Open Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.clineuro.2016.01.014","article-title":"Surgical management and outcome of iatrogenic radial nerve injection injuries","volume":"142","author":"Esquenazi","year":"2016","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e838","DOI":"10.5435\/JAAOS-D-18-00510","article-title":"Management of iatrogenic nerve injuries","volume":"27","author":"Pulos","year":"2019","journal-title":"JAAOS-J. Am. Acad. Orthop. Surg."},{"key":"ref_7","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":"JAAOS-J. Am. Acad. Orthop. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1136\/jnnp.33.5.625","article-title":"Rate of recovery in motor and sensory fibres of the radial nerve: Clinical and electrophysiological aspects","volume":"33","author":"Trojaborg","year":"1970","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"102230","DOI":"10.1016\/j.jcot.2023.102230","article-title":"Humerus shaft fractures, approaches and management","volume":"43","author":"Orapiriyakul","year":"2023","journal-title":"J. Clin. Orthop. Trauma"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e280","DOI":"10.5435\/JAAOS-D-17-00325","article-title":"Updates on and controversies related to management of radial nerve injuries","volume":"27","author":"Chaudhry","year":"2019","journal-title":"JAAOS-J. Am. Acad. Orthop. Surg."},{"key":"ref_11","first-page":"1099","article-title":"Current approach to radial nerve paralysis","volume":"110","author":"Lowe","year":"2002","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Birch, R. (2010). Clinical aspects of nerve injury. Surgical Disorders of the Peripheral Nerves, Springer.","DOI":"10.1007\/978-1-84882-108-8"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s12306-025-00925-6","article-title":"Diaphyseal fractures of the humerus with radial nerve injury: How to manage both fracture and the nerve injury","volume":"110","author":"Maresca","year":"2025","journal-title":"Musculoskelet. Surg."},{"key":"ref_14","first-page":"e11490","article-title":"Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review","volume":"12","author":"Hegeman","year":"2020","journal-title":"Cureus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s00402-020-03446-y","article-title":"Radial nerve palsy associated with closed humeral shaft fractures: A systematic review of 1758 patients","volume":"141","author":"Hendrickx","year":"2021","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jhsa.2003.09.013","article-title":"Radial nerve palsy associated with high-energy humeral shaft fractures","volume":"29","author":"Ring","year":"2004","journal-title":"J. Hand Surg. Am."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s12306-016-0414-3","article-title":"Humerus shaft fracture complicated by radial nerve palsy: Is surgical exploration necessary?","volume":"100","author":"Rocchi","year":"2016","journal-title":"Musculoskelet. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s00402-009-0951-4","article-title":"The management of humeral 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_19","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.jseint.2023.02.003","article-title":"Recovery and functional outcome after radial nerve palsy in adults with a humeral shaft fracture: A multicenter prospective case series","volume":"7","author":"Verhofstad","year":"2023","journal-title":"JSES Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"185","DOI":"10.12671\/jkfs.2014.27.3.185","article-title":"Associated factors of radial nerve palsy combined with humerus shaft fracture","volume":"27","author":"Lee","year":"2014","journal-title":"J. Korean Fract. Soc."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Rasuli\u0107, L., Djura\u0161kovi\u0107, S., Laki\u0107evi\u0107, N., Lepi\u0107, M., Savi\u0107, A., Gruji\u0107, J., Mi\u0107i\u0107, A., Radojevi\u0107, S., Puzovi\u0107, V., and Maleti\u0107, M. (2021). Surgical treatment of radial nerve injuries associated with humeral shaft fracture\u2014A single center experience. Front. Surg., 8.","DOI":"10.3389\/fsurg.2021.774411"},{"key":"ref_22","first-page":"690","article-title":"Radial nerve injuries and outcomes: Our surgical experience","volume":"27","author":"Temiz","year":"2021","journal-title":"Turk. J. Trauma Emerg. Surg.\/Ulus. Travma VE Acil Cerrahi Derg."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1427\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T14:01:09Z","timestamp":1784728869000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":22,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["medicina62071427"],"URL":"https:\/\/doi.org\/10.3390\/medicina62071427","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]}}}