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This study investigates how well ultrasound imaging can identify damage to the radial nerve in patients with a broken upper arm bone (humeral shaft fracture). Some of these patients also have weakness or paralysis in their hand and wrist due to injury to the radial nerve. The study compares patients with and without radial nerve problems to see if early ultrasound scans can accurately detect nerve damage before surgery.
All patients will receive standard care, including surgery to fix the fracture. Those with nerve problems will also have the nerve explored during surgery. The results of the ultrasound will be compared to what is found during the operation. Patients will be followed closely over 12 months to monitor nerve recovery, healing of the bone, and any complications.
The goal is to improve the early diagnosis and management of nerve injuries in arm fractures, using a safe, non-invasive ultrasound scan that could help guide treatment decisions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Radial Nerve Palsy Group | Patients with humeral shaft facture and Radial Nerve Palsy |
| |
| No radial Nerve Palsy | Patients with humeral shaft fracture but no radial nerve palsy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High-Resolution Ultrasound Evaluation of the Radial Nerve | Device | High-resolution diagnostic ultrasound of the radial nerve is performed using a linear transducer (6-15 MHz) within 48 hours of admission in patients with humeral shaft fractures. The ultrasound systematically assesses the radial nerve's continuity, morphology, and relation to the fracture site. Based on established classification criteria (e.g., stretch neuropraxia, incarceration, partial/complete transection), the ultrasound findings guide intraoperative planning. All imaging is performed by board-certified musculoskeletal radiologists following a standardized protocol. |
| Measure | Description | Time Frame |
|---|---|---|
| Preoperative Ultrasound Accuracy in Detecting Radial Nerve Continuity | This outcome assesses how accurately high-resolution ultrasonography identifies whether the radial nerve is intact in patients with humeral shaft fractures and radial nerve palsy. The ultrasound findings will be compared to surgical exploration results (reference standard). Diagnostic accuracy metrics include sensitivity, specificity, positive predictive value, and negative predictive value. | Baseline (within 48 hours of admission); confirmation at surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation Between Ultrasound Classification and Intraoperative Radial Nerve Findings | Ultrasound-based classification of radial nerve injury (e.g., stretch, incarceration, partial/complete transection) will be compared with intraoperative findings to assess diagnostic agreement. Additional analyses will evaluate the relationship between USG classification and postoperative functional outcomes | Baseline (ultrasound), Intraoperative, and Postoperative (3, 6, and 12 months) |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients presenting with acute traumatic humeral shaft fractures at a tertiary care orthopedic center. Patients are assigned to cohorts based on the presence or absence of clinical radial nerve palsy. All participants undergo standard diagnostic and therapeutic procedures, with targeted ultrasound used for nerve assessment in the radial palsy group.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mehmed Nuri Tutuncu, MD | Contact | 0090 531 265 33 79 | mnuritutuncu@hotmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul Medeniyet University | Recruiting | Istanbul | Kars | 34722 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D020425 | Radial Neuropathy |
| ID | Term |
|---|---|
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
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| Functional Recovery of Radial Nerve Motor and Sensory Function | Recovery of motor function (wrist/finger/thumb extension) will be evaluated using the Medical Research Council (MRC) scale (0-5). Sensory recovery will be assessed via light touch and pinprick sensation in the radial nerve territory. Outcomes include proportion of patients with full, partial, or no recovery, and time to initial and full improvement. | 1, 3, 6, and 12 months postoperatively |