Bilal Ahmad Abbas, Farooq Azam Khan, Talha Qureshi.
Iatrogenic Radial Nerve Palsy in the Management of Midshaft Humerus Fracture with Dynamic Compression Plate on Anterolateral versus Anteromedial Surface through Henry Approach.
J Sharif Med Dent Coll Jan ;7(02):66-70.

Objective: To compare the frequency of iatrogenic radial nerve palsy after the management of midshaft humerus fractures with dynamic compression plate on the anterolateral versus anteromedial surface through Henry approach. Methodology: It was a cross-sectional comparative study conducted at the Orthopedic Department, Allied Hospital, Faisalabad after taking approval from the Institutional Ethical Review Committee. The study was conducted from January to June 2018. Eighty patients were included in this study by non-probability consecutive sampling technique. Informed consent was taken from each participant of the study. Patients of both genders aged 18 to 70 years with isolated fracture shaft of humerus or non-union after conservative management, were included in this study. Patients with polytrauma, history of previous surgery on the same humerus, and preoperative radial nerve injury were excluded. Patients with non-union of the humerus after conservative management were enrolled through the outpatient department. Patients presented in the emergency department with a history of trauma and fracture shaft of the humerus were also included in this study. Patients were divided into two groups A and B, each group included 40 patients. Group A was treated with a dynamic compression plate applied through Henry approach on the anterolateral surface and in group B, the plate was applied on the anteromedial surface through the Henry approach. Results: Mean age was 34.79+/-9.73 years in group A and 32.76+/-8.01 years in group B. In group A, 8(20%) patients had radial nerve injury and 32(80%) patients did not have nerve injury. In group B, 1(2.50%) had radial nerve injury and 39(97.50%) had no findings of nerve injury. A statistically significant difference was found when postoperative radial nerve injury was compared in both groups (p-value=0.02). At 2nd follow-up after three months of surgery, radial nerve injury in eight patients (100%) of group A and one (100%) of group B was settled. Conclusion: Iatrogenic radial nerve palsy is significantly lower in patients treated with dynamic compression plate on the anteromedial surface as compared to the anterolateral surface through Henry approach in midshaft humerus fracture. Keywords: Humeral fracture. Radial nerve injury. Henry approach.

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