|
|
第57卷 第2期 2024-3
Necrotizing fasciitis resulted from foreign body ingestion and intestinal perforation in an incisional hernia: Report of a case |
| ......................... |
|
第57卷 第2期 2024-3
Application of artificial intelligence in endodontic microsurgery |
| ......................... |
|
第57卷 第2期 2024-3
A rare case of cerebral metastasis of malignant peripheral nerve sheath tumor in a patient with neurofibromatosis type 1 |
| ......................... |
|
第57卷 第2期 2024-3
Ethic in commenting and clinical surgery journal publication: Emerging issue in the era of social media—A story from “Beall” to “Jaime” and independent researcher |
| ......................... |
|
第57卷 第2期 2024-3
Ophidascaris robertsi, the new emerging human parasite and neurosurgery |
| ......................... |
|
第57卷 第2期 2024-3
Tetanus toxoid IgG, usefulness in clinical surgery, and diagnostic property limitation |
| ......................... |
|
第57卷 第2期 2024-3
Deaths among surgeons while on duty: An important issue in surgery and occupational medicine that should not be disregarded |
| ......................... |
|
第57卷 第2期 2024-3
ChatGPT and its use in clinical surgery: A comment on its pro and con |
| ......................... |
|
第57卷 第2期 2024-3
Isolated spinal neurocysticercosis and pseudotumor cerebri: Tropical problem to be noted |
| ......................... |
|
第57卷 第2期 2024-3
Management of massive hemothorax resulting from traumatic diaphragm rupture with kidney avulsion injury by combined anterior thoracoabdominal approaches |
| ......................... |
|
第57卷 第2期 2024-3
Laparoscopic partial splenectomy for sclerosing angiomatoid nodular transformation: A case report and literature review |
| ......................... |
|
第57卷 第2期 2024-3
Using three-dimensional versus two-dimensional laparoscopy in sleeve gastrectomy: A case matched comparison |
| ......................... |
|
第57卷 第2期 2024-3
Effectiveness of placing prophylactic mesh with the Sugarbaker technique via laparoscopic abdominoperineal resection for rectal cancer: 1-year results |
| ......................... |
|
第57卷 第2期 2024-3
Nylon cable ties–assisted delay primary closure of fasciotomy wound in patients of forearm compartment syndrome |
| ......................... |
|
第57卷 第2期 2024-3
Prefabricated venous fl ap, an advanced free venous fl ap for distant transfer: An experimental rat study |
| ......................... |
|
第57卷 第1期 2024-1
Isolated lower leg monoplegia due to traumatic intraparenchymal hemorrhage |
| ......................... |
|
第57卷 第1期 2024-1
Reflections on the association between cholecystectomy, cholelithiasis, and colorectal cancer |
| ......................... |
|
第57卷 第1期 2024-1
Molluscum contagiosum, false positive, and incidence: Concern in surgery |
| ......................... |
|
第57卷 第1期 2024-1
New form of COVID-19 vaccine: A new advanced technology for fighting the remained problem |
| ......................... |
|
第57卷 第1期 2024-1
COVID-19 vaccination, acute appendicitis, interrelationship, and jointed probability: A concern |
| ......................... |
|
 |
| 篇名 |
Prognostic factors for radial nerve palsy associated with humeral shaft fracture |
| 作者 |
Yen-Yi Hoa, Lee-Wei Chen, Kao-Chang Yang, Kuei Chang Hsu, Wen-Chung Liu, Cheng-Ta Lin |
| 卷期/出版年月 |
50卷1期 (2017/2) |
| 頁次 |
1-9 |
| 摘要 |
Background: Radial nerve palsy (RNP) associated with humeral shaft fracture is a common injury pattern in trauma patients. The management of RNP associated with humeral fractures in high-energy trauma is controversial and poses a challenge to surgeons treating it.
Purpose: Based on a review of our experience over the past 15 years, we determined the prognostic factors of radial nerve recovery after humeral fractures, evaluated the diagnostic role of nerve conduction studies
and electromyography (EMG), and compared the outcomes of different treatment strategies.
Materials and Methods: The data of 26 patients having RNP associated with humeral shaft fractures over a 15-year period were collected for a retrospective review. For statistical analysis, the patients were divided
into groups on the basis of their recovery from RNP and the treatment strategies used.
Results: The incidence of RNP associated with humeral fractures was 2.05%. In total, 91.3% of patients with primary RNP in this series experienced high-energy trauma. Spontaneous recovery was observed in 9 of 26 patients (34.6%). Radial nerve lesions were found in 7 of 8 patients with high-energy trauma. The severity of humeral shaft fractures was found to be a significant prognostic factor for spontaneous recovery from RNP. The rate of spontaneous recovery was significantly higher in the AO Foundation
and Orthopaedic Trauma Association Type A humeral shaft fractures (P = 0.028) and lower in Type C fractures (P = 0.055). The median time to detect initial radial nerve recovery using EMG was 34 and 75 days after injury (P = 0.033). In high-energy trauma, tendon transfers were associated with more
predictable outcomes than nerve reconstruction (favorable functional recovery: 100% for tendon transfers vs. 25% for nerve reconstruction, P = 0.007). Moreover, tendon transfers were associated with a shorter
overall treatment duration (median treatment duration: 190 days for tendon transfers vs. 422 days for nerve reconstruction, P = 0.007).
Conclusion: The prognosis of RNP associated with humeral shaft fractures in high-energy trauma is less favorable, with a low rate of spontaneous recovery. EMG is helpful for the early detection of initial nerve
recovery. The outcomes of tendon transfers in high-energy trauma are predictable and the treatment duration is shorter. First-intention tendon transfer is a reasonable treatment strategy in patients with difficult nerve
exploration, lower requirement for functional recovery, and lower compliance with treatment. |
| 關鍵詞 |
Electromyography, nerve conduction studies, nerve reconstruction, nerve recovery, tendon transfer |
| 分類 |
Original Article |
|
