Delayed neuroapraxia of the radial nerve after non-surgical management of humerus fracture due to entrapment in bone callus. Case report

Abstract

Background: Fractures of the shaft of the humerus are frequent, with bimodal distribution in the population. Non-surgical management with immobilization and a functional brace is considered the gold standard with some specific complications that can occur early or late during treatment. The entrapment of the radial nerve by the bone callus with neurological involvement is a rare event reported in literature.
Methods: Two cases of late radial nerve neuropraxia are described in patients who suffered simple line fractures who met criteria for nonsurgical treatment. A narrative review of the literature in known databases was carried out looking for similar cases to optimize medical management.
Results: The clinical outcomes of the two cases that underwent surgery by the same surgeon and that shared the same diagnoses of radial nerve entrapment due to bone callus during initial non-surgical treatment are presented. The results of the narrative review of the literature are reported.
Discussion: Neuropraxia of the radial nerve due to entrapment in bone callus in the first days of a non-surgical treatment for fractures of simple lines in the diaphysis of the humerus is a rare but possible complication that confirms the need for strict monitoring of the patient.
Evidence Level: IV.