Almalki Mohammed Musaed, Alrashedan Bander S, Alragea Ahmed Shaya, Alshihri Adel Faiz, Serhan Hani S, AlFashtaki Husam Fahmi
Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
Department of Orthopedic Surgery, King Salman Armed Forces Hospital, Tabuk, Kingdom of Saudi Arabia.
J Brachial Plex Peripher Nerve Inj. 2025 Aug 19;20(1):e53-e58. doi: 10.1055/a-2596-1347. eCollection 2025 Jan.
Peripheral brachial plexus injuries, particularly Radial nerve palsy (RNP), are a common complication of humeral shaft fractures. Despite previous research, the specific fracture patterns associated with RNP remain unclear.
This study aims to assess the frequency and patterns of humeral shaft fractures, determine the incidence of peripheral brachial plexus injuries such as radial and ulnar nerve palsies, and investigate the association between specific fracture patterns and these nerve injuries. We also explored other factors influencing RNP development and identified potential risk factors or predictors.
This retrospective cohort study analyzed 144 patients with humeral shaft fractures at King Saud Medical City from 2015 to 2022. Patient data, such as age, gender, and neurovascular status, were extracted and analyzed using SPSS. RNP was diagnosed clinically. Statistical analyses included chi-square and student -tests, with a -value of <0.05 for significance.
This study found a 37.5% incidence of RNP in humeral shaft fractures. Significant differences were observed in age ( = 0.032) and mechanism of injury ( < 0.0001), with most fractures due to road traffic accidents (72.22%) and closed (93.75%). Common fracture patterns were AO 12A (37.5%) and AO 12B (39.58%), with a higher prevalence of comminuted fractures (71 cases). Significant differences in fracture patterns ( < 0.0001) and anteromedial comminution ( = 0.002) were noted between patients with and without RNP. Interestingly, four cases of concomitant ulnar nerve palsy were observed in patients with radial nerve palsy. However, no significant differences were found in gender ( = 0.343), open fractures ( = 0.214), or associated fractures ( = 0.106).
This study suggests that the severity of trauma, rather than specific fracture patterns, is a more significant factor in RNP development in humeral shaft fractures. Further research is needed to understand the underlying biomechanics.
臂丛神经周围损伤，尤其是桡神经麻痹（RNP），是肱骨干骨折的常见并发症。尽管此前已有相关研究，但与RNP相关的具体骨折类型仍不明确。
本研究旨在评估肱骨干骨折的发生频率和类型，确定桡神经和尺神经麻痹等臂丛神经周围损伤的发生率，并研究特定骨折类型与这些神经损伤之间的关联。我们还探讨了影响RNP发生的其他因素，并确定了潜在的危险因素或预测因素。
这项回顾性队列研究分析了2015年至2022年在沙特国王医疗城的144例肱骨干骨折患者。提取患者的年龄、性别和神经血管状况等数据，并使用SPSS进行分析。RNP通过临床诊断。统计分析包括卡方检验和t检验，P值<0.05具有统计学意义。
本研究发现肱骨干骨折患者中RNP的发生率为37.5%。在年龄（P = 0.032）和损伤机制（P < 0.0001）方面观察到显著差异，大多数骨折是由道路交通事故（72.22%）和闭合性骨折（93.75%）引起的。常见的骨折类型是AO 12A（37.5%）和AO 12B（39.58%），粉碎性骨折更为常见（71例）。有RNP和无RNP的患者在骨折类型（P < 0.0001）和前内侧粉碎情况（P = 0.002）方面存在显著差异。有趣的是，在桡神经麻痹患者中观察到4例合并尺神经麻痹。然而，在性别（P = 0.343）、开放性骨折（P = 0.214）或合并骨折（P = 0.106）方面未发现显著差异。
本研究表明，在肱骨干骨折中，创伤的严重程度而非特定的骨折类型是RNP发生的更重要因素。需要进一步研究以了解其潜在的生物力学机制。
