Noaman Hassan, Khalifa Abdel Rahman, El-Deen Mohamed Alam, Shiha Anis
Orthopaedic Department, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt.
Microsurgery. 2008;28(8):635-42. doi: 10.1002/micr.20542.
The series included 36 patients, predominantly male, mean age 30.3 years. The most common cause of injury was motor car accident in 20 patients. Postreduction radial nerve injury occurred in nine cases. Open fracture humerus with radial nerve injury in seven cases. The fractures were situated in the middle or distal third of the humeral shaft. Most were transverse fractures. Twelve patients had surgery on the day of injury and the other 24 at a mean of 8 days later (3-14). Narrow dynamic compression plate was generally used for fixation. Exploration of the radial nerve demonstrated compression at the lateral intermuscular septum in 19 cases, entrapment in the fracture site in nine cases, and loss of its continuity in eight cases. Neurolysis was required in 20 cases, epineurorrhaphy in nine cases, interfascicular nerve grafts in five, and first-intention tendon transfer in two. Results of nerve surgery were assessed with the MRC (Medical Research Council) at a mean follow-up of 8.2 years. Outcome was rated good to excellent in 28 patients, fair in 1, and poor (failure) in 3. First-intention tendon transfers were performed in 2 patients and 2 patients were lost to follow-up. Mean delay to recovery was 7 months after neurolysis and nerve repair and 15 months after nerve grafts. The fracture was united in all cases. The mean time of union was 5 months.
该系列包括36例患者，以男性为主，平均年龄30.3岁。最常见的损伤原因是20例患者发生的机动车事故。复位后桡神经损伤9例。开放性肱骨骨折合并桡神经损伤7例。骨折位于肱骨干的中1/3或远1/3处。大多数为横行骨折。12例患者在受伤当天接受手术，另外24例平均在8天后（3 - 14天）接受手术。一般使用窄动力加压钢板进行固定。对桡神经的探查显示，19例在外侧肌间隔处受压，9例在骨折部位受压，8例连续性中断。20例需要进行神经松解术，9例进行神经外膜缝合术，5例进行束间神经移植，2例进行一期肌腱转移术。在平均随访8.2年时，用医学研究委员会（MRC）评估神经手术结果。28例患者结果评定为良好至优秀，1例为尚可，3例为差（失败）。2例患者进行了一期肌腱转移术，2例患者失访。神经松解术和神经修复术后平均恢复延迟7个月，神经移植术后为15个月。所有病例骨折均愈合。平均愈合时间为5个月。
