Perioperative diagnosis of injuries of the radial nerve in closed humeral shaft fracture and evaluation of the feasibility of its primary exploration

The problem of injuries of the radial nerve in humeral shaft fracture remains relevant. These complications are quite common and are characterized by a long period of treatment and a significant number of unsatisfactory outcomes. The approach to the diagnosis and treatment of such injuries is ambiguous, one of the debatable issues is the expediency of the early surgical management of radial nerve palsy.The purpose of this study is to substantiate the use of the ultrasonic method for perioperative diagnosis of radial nerve damage in fractures of the humeral shaft in the early period after injury and to determine the indications for the revision of the damaged radial nerve in the performance of osteosynthesis.Patients with humeral shaft fractures complicated by traumatic injury of the radial nerve were performed ultrasound examination of the radial nerve in the perioperative period. 43 patients were examined. The continuity of the nerve, its relationship with bone fragments and elements of metal implants were evaluated. On the basis of the obtained data, the decision was made on the expediency of the radial nerve surgical exploration during osteosynthesis. The results of imaging of the radial nerve at ultrasound coincided with intraoperative findings.Conclusions about the purposefulness of ultrasound examination in the early period after injury, tasks, timing and technique of the study.