Abstract text (incl. references and figure legends)
Objectives
Iatrogenic radial nerve palsy (RNP) is a well known complication when plating humeral shaft fractures with even an increased risk when plate removal is indicated. Bridging the nerve by a bended plate should allow plate removal in secondary surgery without RNP. Primary outcome is radial nerve palsy after removal of the radial nerve protection plate . Secondary outcome is the incidence of nonunion after primary surgery. Methods Retrospective , consecutive series. The Radial Nerve Protection Plate technique (RNPP) was introduced in may 2013 . Patients were included untill dec 2021, having at least 6 months follow up . In all patients the radial nerve was explored and subsequently bridged by the bended plate. Results In total 34 patients were included. 21 female, 13 male. Mean age was 62 y (range 17-91) . There were two preoperative RNP. 23 patients received a lateral plate through a direct lateral approach , 11 patients received a posterior plate through a posterior approach. 8 patients ( 23%) experienced a temporary RNP after primary surgery . There were 2 nonunions and 1 peri-implant fracture. In 7 patients the plate was removed after a mean of 14 months ( range 8-17) of which 6 lateral and 1 posterior. Reasons for removal were 4 times hindrance, 2 nonunions and 1 peri-implant fracture. There were no RNP after secondary surgery. One patient in whom we used cauterisation to clear the plate at the level of the radial nerve experienced a two day weakness in wrist dorsiflexion. Conclusions The RNPP technique avoids radial nerve palsy in case of removal of the plate without impeding primary fracture healing. When clearing the plate , avoid cauterization of the plate near the radial nerve
Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
no