Radial nerve palsy associated with humeral shaft fracture. Is the energy of trauma a prognostic factor?
The outcome of the radial nerve palsy following humeral fractures is associated to the initial trauma. Palsies that are part of a low energy fracture uniformly recover and therefore primary surgical exploration seems unnecessary. In high energy fractures, neurotmesis or severe contusion must be expected. In this case nerve recovery is unfavourable and the patients should be informed of the poor prognosis and the need of tendon transfers.
Our studies demonstrate for the first time that MMV are characterized by reduced levels of MT1/2 accompanied by an up-regulation of TGF-β2. In turn, increased TGF-β2 signalling induces down-regulation of aggrecanases and up-regulation of versican, two co-operating processes that potentially participate in the development of the pathology.