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CC BY 4.0 · J Brachial Plex Peripher Nerve Inj 2025; 20(01): e53-e58
DOI: 10.1055/a-2596-1347
Original Article

Fracture Patterns and Peripheral Brachial Plexus Injury in Humerus Fractures: A Retrospective Study

Autor*innen

  • Mohammed Musaed Almalki 

    1   Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia

  • Bander S. Alrashedan

    1   Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia

  • Ahmed Shaya Alragea

    2   Department of Orthopedic Surgery, King Salman Armed Forces Hospital, Tabuk, Kingdom of Saudi Arabia

  • Adel Faiz Alshihri

    1   Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia

  • Hani S Serhan

    1   Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia

  • Husam Fahmi AlFashtaki

    1   Department of Orthopedic Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia

Funding None.
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Abstract

Background

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.

Objectives

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.

Methods

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 t-tests, with a p-value of <0.05 for significance.

Results

This study found a 37.5% incidence of RNP in humeral shaft fractures. Significant differences were observed in age (p = 0.032) and mechanism of injury (p < 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 (p < 0.0001) and anteromedial comminution (p = 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 (p = 0.343), open fractures (p = 0.214), or associated fractures (p = 0.106).

Conclusion

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.

Keywords

humeral shaft fracture - radial nerve palsy - fracture pattern - retrospective cohort - trauma severity - biomechanics


Publikationsverlauf

Eingereicht: 28. Oktober 2024

Angenommen: 28. April 2025

Artikel online veröffentlicht:
19. August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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