Objective: To investigate the surgical treatment of mid-distal humeral shaft fractures associated with radial nerve palsysis with minimal invasive screwed nails osteosynthesis technique.
Methods: Thirty-six patients treated mid-distal humeral shaft fractures associated with radial nerve palsysis from January 2004 to January 2008. There were 28 males and 8 females whose age ranged from 20- to 58-years-old with an average of 36.5-years-old. Injury reasons: mechanical injury 18 cases, traffic injury 8 cases, accidents injury 10 cases, all cases were closed fracture. According to AO/ASIF classification, type A1 5 cases, type A2 7 cases, type B1 8 cases, type B2 7 cases, type B3 5 cases, type C3 4 cases. The small lateral incision was performed located to the fracture. After exploration of the radial nerve, the fractures were reduced. By acromion small lateral incision, the deltoid was separated. In the posterior macronodular slotted antegrade reamed bored with medullary cavity drill and selected a suitable screwed nail screwed into the medullary cavity distal. Along the slot, the locking pieces were inserted to complete the fixation. The postoperative complication, fracture healing time, radial nerve function recovery time, the motion of shoulder and elbow were recorded.
Results: The incision of all cases healed with stage I . The patients were followed up for 9-36 weeks with an average of 18.5 weeks. The X-ray examination showed fractures healing in 12-16 weeks (average of 15.6 weeks). Radial nerve function recovered fully at 12-36 weeks after operation (average of 17.8 weeks). Shoulder abduction is 150 degrees-170 degrees with an average of 160 degrees; elbow motion of activities was 130 degrees-140 degrees with an average of 135 degrees. The ASES method was used to assess the shoulder joint function, 20 cases gained the excellent result, 12 good and 4 poor. And according to HSS method, 36 cases of elbow joint function gained the excellent result.
Conclusion: The surgical treatment of mid-distal humeral shaft fractures associated with radial nerve palsysis with minimal invasive screwed nails osteosynthesis technique is effective.