![]() There was no consensus between observation and early exploration. The management of radial nerve injuries associated with humeral fractures is debating. In 15 cases the nerve was totally divided (11.19%), and 119 cases were partially divided or integrated. Total 134 patients with radial nerve injury accepted early or delay exploration. ![]() Eleven –, ,, ,, , studies reported the damage degree of radial nerve after exploration. A pooled analysis of the studies found no significant difference between these two groups (OR, 1.22, 95% CI 0.72, 2.07 I 2 = 0.0%, p = 0.453 n.s.) ( Fig. And Six, , – compared nerve functional recovery of delay exploration with no exploration. A pooled analysis of the studies found no significant difference between these two groups (OR, 1.03, 95% CI 0.61, 1.72 I 2 = 0.0%, p = 0.918 n.s.) ( Fig. In these studies, Six –, ,, compared nerve functional recovery of early exploration with no exploration. Thirteen –, ,, ,, , studies favored conservative strategy delayed exploration was performed if no nerve recovery was found with 5–8 weeks. And eight, ,, ,, ,, , did not state a clear preference. One discussed an observation and delayed exploration strategy after secondary radial nerve palsy. Five, – proposed early exploration was performed in high-energy humeral shaft fractures. Three, , recommend early radial nerve exploration (within the first 2 weeks) in patients with open fractures of humerus with radial nerve injury. Thirteen –, ,, ,, , favored a conservative strategy delayed exploration was performed if no nerve recovery was found with 5–8 weeks. After comparing these articles, all sorts of controversies were appeared. Twenty-six studies were published in English –, –, ,, – and four studies, ,, were published in German. In the thirty studies, 2952 humeral fractures participants were identified. The purpose of this study was to discuss an integrated management strategy for determining the management procedure when deal with all kinds of humeral fractures with complete sensory and motor radial nerve palsy. Exploration of open fractures with radial nerve dysfunction is now generally agreed on, but all of the recommendations for exploring the radial nerve in closed injuries have been challenged. Radial nerve transection is uncommon and is usually associated with an open fracture. In most cases the radial nerve is intact and the prognosis for complete or functionally useful recovery is favourable. Nerve function recovery is often spontaneous in closed fractures within a period ranging from few weeks to several months. ![]() However, the optimal management strategy for radial nerve palsy in the setting of a humeral shaft fracture remains controversial. These can be divided into three categories depending on occurrence time: primary, delayed and secondary. Radial nerve palsy associated with fractures of the shaft of the humerus is the most common nerve lesion complicating fractures of long bones. With the development of internal fixation technology, indications for operation expand while new debates on procedure choice appear. However, surgical management is required in special situations such as polytrauma, open or bilateral fractures, floating elbow, and obesity. With acceptable reduction and union, most humeral shaft fractures can be treated conservatively. Early studies suggested that high-energy trauma and injuries in younger patients were more likely associated with this fracture. Fractures of the shaft of the humerus account for 1% to 3% of all fractures.
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