ArticleArchives of orthopaedic and trauma surgery2025
"Natural history of low velocity ballistic nerve injuries to the humerus".
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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Who cites it
1 citing paper in PubMed.
- Delayed Radial Nerve Recovery After Ballistic vs. Blunt Humeral Shaft Fractures: A Time-to-Recovery Analysis of Nerves in Continuity.Journal of clinical medicine · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess ballistic humerus fractures with nerve injuries, their associated characteristics, and functional recovery.
designRetrospective review
settingLevel 1 trauma center over 10-year period. PATIENTS: 143 patients presenting with low-velocity ballistic humerus fractures.
interventionOperative intervention and clinical examination of nerve function. MAIN OUTCOME MEASUREMENTS: Nerve injury incidence and recovery.
resultsThe overall incidence of nerve injury was 21% (30 injuries/143 fractures) with 66.7% of fractures treated operatively. Nerve injury varied based on anatomic region: 28.6% (12/42) distal humerus; 20% (15/75) shaft and, 11.5% (3/26) proximal humerus. Arterial injury (p = 0.011) and bone loss (p = 0.0001) were significantly associated with nerve injury. The nerve was visualized during index surgery in 15 patients, with 4 transections. Multiple nerve injuries (n = 6) were most common around the distal humerus: 41.7% (5/12). The radial nerve comprised 52.9% (n = 9) of injuries in the distal humerus and 62.5% (n = 10) in the shaft with spontaneous recovery occurring in 75% (6/8) with distal fractures and 66.7% (6/9) with shaft fractures. The ulnar nerve accounted for 35.3% (n = 6) of injuries in the distal humerus and 25% (n = 4) in the shaft. Spontaneous recovery occurred in 60% (3/5) of ulnar nerve injuries around distal fractures but in only 25% (1/4) in the shaft. Half of ulnar nerve injuries were associated with additional nerve or vascular injury. The median nerve was the least likely to be injured: 40% (n = 2) distal humerus, 40% (n = 2) shaft, and 20% (n = 1) proximal humerus and 40% (2/5) spontaneously recovered.
conclusionIn the setting of ballistic humerus fractures, arterial injury and bone loss were significantly associated with nerve injury. Multiple nerve injury occurred most commonly at the distal humerus. There was a 60-75% recovery rate of most nerve injuries however, ulnar nerve injuries around the shaft and median nerve injuries had lower rates of recovery. LEVEL OF EVIDENCE: Level III.
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