Frequency of Radial Nerve Injury in Closed Fracture Shaft of Humerus

Abstract

Background:
Radial nerve injury is one of the most common neurological complications associated with closed fractures of the shaft of the humerus because of the close anatomical relationship between the radial nerve and the humeral shaft. Early recognition of nerve involvement is important for appropriate management and prevention of long-term functional disability.

Objective:
To determine the frequency of radial nerve injury among patients presenting with closed fractures of the shaft of the humerus in a tertiary-care hospital.

Methods:
This descriptive cross-sectional study was conducted in the Department of Orthopedic Surgery at a tertiary-care hospital affiliated with the University of Balochistan. A total of 164 patients aged 18–60 years with radiologically confirmed closed humeral shaft fractures were included using non-probability consecutive sampling. Patients with open fractures, pathological fractures, polytrauma, previous neurological disorders, and vascular injuries were excluded. Clinical and radiological assessments were performed to evaluate fracture characteristics and radial nerve involvement. Data were analyzed using SPSS version 26. Quantitative variables were expressed as mean ± standard deviation, while qualitative variables were presented as frequencies and percentages.

Results:
Among 164 patients with closed humeral shaft fractures, radial nerve injury was identified in 18 (10.97%) patients. Male patients demonstrated a slightly higher frequency of nerve injury compared with females. Spiral and oblique fracture patterns showed greater association with radial nerve palsy than transverse and comminuted fractures. Middle-third humeral shaft fractures were the most common anatomical location associated with nerve injury. Primary radial nerve palsy was observed more frequently than secondary palsy.

Conclusion:
Radial nerve injury is a frequent complication of closed humeral shaft fractures, particularly in middle-third spiral and oblique fractures. Careful neurological assessment at initial presentation is essential for early diagnosis and appropriate management. The findings provide valuable regional epidemiological data and support the importance of standardized clinical evaluation protocols in patients with humeral shaft fractures.