Radial nerve palsy associated with fractures of the shaft of the humerus: A systematic review

Background

Radial nerve palsy is the most common peripheral nerve injury complicating fractures of the humeral shaft. Itsoptimal management — early surgical exploration versus initial expectant observation — has remained contentious fordecades. We systematically reviewed the published evidence to define the prevalence of radial nerve palsy, its relationship tofracture pattern and location, and the rates of nerve recovery following the principal management strategies. Materials andMethods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews andMeta-Analyses (PRISMA) 2020 statement. PubMed/MEDLINE, Embase, the Cochrane Library and Google Scholar weresearched from inception to April 2026 for studies reporting radial nerve palsy associated with humeral shaft fractures. Tworeviewers independently screened records, extracted data and appraised methodological quality. Pooled proportions werederived for prevalence, association with fracture morphology and rates of nerve recovery under expectant and operativemanagement.