The Upper Hand: Chuck & Chris Talk Hand Surgery

Humerus Fracture with Radial Nerve Palsy, Part 1

Mar 16, 2025

The discussion dives into radial nerve palsy linked to humerus fractures, exploring diagnosis and treatment options. Highlights include patient expectations surrounding nerve injuries and the importance of timely surgical interventions. The hosts reflect on their fellowship experiences, share stories of impressive applicants, and talk about exciting professional opportunities. The conversation also touches on the recovery process and the critical role of hand therapists in managing patient outcomes.

36:05

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Quick takeaways

The podcast emphasizes the importance of initial examination techniques and the role of patient history in managing radial nerve injuries effectively.

A significant theme is the consideration of patient-centered decision-making in choosing between nerve transfers and tendon transfers for treatment options.

Deep dives

Fellowship Interview Day Highlights

The episode discusses the excitement surrounding the annual fellowship interview day where thirty-two candidates aspiring to become hand surgeons were welcomed. Both speakers express their admiration for the impressive qualifications of the applicants, which leaves them optimistic about the future of hand surgery. They share their experiences of past interviews, highlighting different formats, such as extended observation periods in surgery, which help candidates get a real sense of the fellowship environment. This process is valuable not only for evaluating candidates but also for providing insights into their potential as future surgeons.

Intro

2min

Reflections on Fellowship and Upcoming Changes

2min

Exciting Travels and Professional Opportunities

2min

Managing Humerus Fractures and Radial Nerve Palsy

17min

Surgical Strategies and Patient Collaboration in Radial Nerve Injuries

3min

Navigating Radial Nerve Recovery

9min

Chuck and Chris discuss a radial nerve palsy associated with a humerus fracture. We discuss diagnosis, examination, and preliminary treatment options. Part 2 will follow after the IFSSH meeting. We also discuss upcoming, IFSSH- related episodes.

Some citations

1: Lieberdorfer A, Shivakumar N, Stonner MM, Brogan DM, Ray WZ, Mackinnon SE, Dy
CJ. Expectant Management, Tendon Transfer, or Nerve Transfer Surgery for Radial
Nerve Injury: A Qualitative Study Exploring Patient Expectations, Goals, and
Treatment Experiences. J Bone Joint Surg Am. 2023 Apr 19;105(8):600-606. doi:
10.2106/JBJS.22.01201. Epub 2023 Feb 16. PMID: 36795855.

2: Malikowski T, Micklesen PJ, Robinson LR. Prognostic values of
electrodiagnostic studies in traumatic radial neuropathy. Muscle Nerve. 2007
Sep;36(3):364-7. doi: 10.1002/mus.20848. PMID: 17587226.

3: Steenbeek ED, Pondaag W, Tannemaat MR, Van Zwet EW, Malessy MJA, Groen JL.
Optimal timing of needle electromyography to diagnose lesion severity in
traumatic radial nerve injury. Muscle Nerve. 2023 Apr;67(4):314-319. doi:
10.1002/mus.27787. Epub 2023 Jan 22. PMID: 36625338.

4. PMID: 31714418
Radial Nerve Palsy Recovery With Fractures of the Humerus: An Updated Systematic Review.
Ilyas AM, Mangan JJ, Graham J.
J Am Acad Orthop Surg. 2020 Mar 15;28(6):e263-e269. doi: 10.5435/JAAOS-D-18-00142.

5. PMID: 32285189
Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients.
Hendrickx LAM, Hilgersom NFJ, Alkaduhimi H, Doornberg JN, van den Bekerom MPJ.
Arch Orthop Trauma Surg. 2021 Apr;141(4):561-568. doi: 10.1007/s00402-020-03446-y. Epub 2020 Apr 13.

6. PMID: 33335819
Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review.
Hegeman EM, Polmear M, Scanaliato JP, Nesti L, Dunn JC.
Cureus. 2020 Nov 15;12(11):e11490. doi: 10.7759/cureus.11490.
PMID: 33335819 Free PMC article. Review.

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See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities.

The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/.

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As always, thanks to @iampetermartin for the amazing introduction and concluding music.

For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

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The Upper Hand: Chuck & Chris Talk Hand Surgery

Humerus Fracture with Radial Nerve Palsy, Part 1