Radiolucent cerclage for humerus fractures: beware of radial nerve injury—a case report

Author:

Dadabhoy Maria1,Cuthbert Rory1,Sugand Kapil12ORCID,Vusirikala Anuhya1,Fox Michael1,Panagiotidou Anna1,Sinisi Marco1,Quick Tom13

Affiliation:

1. Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital , Stanmore HA7 4LP , United Kingdom

2. Department of Surgery and Cancer & MSk Lab, Imperial College , London W12 0BZ , United Kingdom

3. Centre for Nerve Engineering, University College London , London WC1N 1AX , United Kingdom

Abstract

Abstract A 73-year-old woman was referred to a National Centre for Peripheral Nerve Injury with a post-operative left radial nerve degenerative lesion following open reduction and internal fixation of a proximal third humerus fracture using radiolucent Arthrex FiberTape® Cerclage as an adjunct to plating to improve stability. Intra-operative photographs illustrate compression of the radial nerve under the cerclage construct. Use of radiolucent cerclage for humerus fractures is increasing with modern systems capable of withstanding an ultimate load of 4300 N. We highlight the risk of debilitating neurological injury when not deployed safely and describe anatomical high-risk zones for injury. We emphasize the impact of delay in diagnosis and treatment.

Funder

Imperial Open Access Fund

Publisher

Oxford University Press (OUP)

Reference9 articles.

1. Arthrex;Fibertape® Cerclage

2. Radial nerve injuries;Ljungquist;J Hand Surg Am,2015

3. Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients;Hendrickx;Arch Orthop Trauma Surg,2020

4. Safe zones for cerclage wiring of the humeral diaphysis;Kadar;Clin Anat,2019

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