Radial nerve palsy associated with humeral shaft fracture: Evaluation withUS - Initial experience

PURPOSE: To determine the feasibility of using ultrasonography (US) for eva luation of a radial nerve injury associated with humeral shaft fracture. MATERIALS AND METHODS: In a prospective study, 11 consecutive patients with sensorimotor radial deficiency after distal humeral fracture were evaluate d with conventional radiography, US, electroneurography, and electromyograp hy. Surgical repair of the fracture and nerve inspection were performed in five patients. The remaining six patients were successfully treated conserv atively. The US appearance of the radial nerve was studied in 10 healthy vo lunteers and in the noninjured arm of the 11 patients for comparison. RESULTS: In five patients, US findings of a severely damaged radial nerve w ere confirmed at surgical nerve inspection. In one patient, the nerve was e ntrapped between fragments. One patient had a complete nerve dissection, on e had a lacerated nerve from a loose compression plate, and one had a nerve riding on the edge of a bone fragment. In the fifth patient who underwent surgical inspection, the nerve was buried in the callus. in the six patient s treated conservatively, US showed continuity of the nerve. CONCLCUSION: US may be useful for accurate evaluation of the radial nerve i n patients with nerve palsy associated with humeral shaft fracture.