This 2015 current concepts review from J Hand Surg Am synthesizes the anatomy, diagnosis, and management of radial nerve injuries, with particular focus on injuries associated with humeral shaft fractures — a setting where the optimal timing of surgical exploration remains actively debated.
When you see a humeral shaft fracture with radial nerve palsy in a closed, low-energy mechanism, the evidence supports observation for up to 6 months before surgical exploration — but open fractures, penetrating injuries, vascular injuries, and failure to show any recovery by 7 months are hard indications to act.
Know that better-than-expected recovery is the rule for radial nerve compared to median or ulnar nerve repairs, especially with primary tension-free repair.
This 2015 current concepts review from J Hand Surg Am synthesizes the anatomy, diagnosis, and management of radial nerve injuries, with particular focus on injuries associated with humeral shaft fractures — a setting where the optimal timing of surgical exploration remains actively debated.
When you see a humeral shaft fracture with radial nerve palsy in a closed, low-energy mechanism, the evidence supports observation for up to 6 months before surgical exploration — but open fractures, penetrating injuries, vascular injuries, and failure to show any recovery by 7 months are hard indications to act.
Know that better-than-expected recovery is the rule for radial nerve compared to median or ulnar nerve repairs, especially with primary tension-free repair.