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Original Research

RMJ. 2019; 44(3): 537-540


Evaluation of radial nerve injury associated with closed humeral shaft fracture by early pre-operative ultrasonic evaluation and correlation with surgical exploration

Zaid W. AL-Shahwanii, Mohammed Sh. Al- Edanni, Mohammed Kahtan Azez.

Abstract
Objective: To assess the sensitivity & specificity of the ultrasound to detect the radial nerve injury and to see if this can be used as a diagnostic test.
Methodology: This is a prospective study on 17 adult patients with a closed fracture of the humeral shaft, dividing into two groups; the first group of 7 patients had signs and symptoms of radial nerve palsy and the second group of 10 patients had intact radial nerve function was considered as a control group. All had at least one indication to fix their fractured humerus, then all patients had evaluated with high-resolution ultrasound (7 Mhz) to assess the radial nerve by the same radiologist with three weeks of injury. All were treated with open reduction and internal fixation with an exploration of the radial nerve and the results were compared.
Results: High-resolution ultrasound showed a low sensitivity and specificity (66.6% and 63.6%, respectively) with low overall accuracy (64%).
Conclusion: Ultrasound cannot be used as a diagnostic test for radial nerve injury associated with closed humeral shaft fracture. However, can show some traumatic pathology which may benefit from early surgical exploration.

Key words: Fracture humerus, radial nerve injury, high-resolution ultrasound.



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