Restoring Motion and Sensation: Physiotherapeutic Strategies for Humeral Shaft Fracture with Radial Nerve Palsy

Abstract

Humeral shaft fractures, though relatively uncommon, pose distinct challenges, especially when accompanied by radial nerve palsy. This case report outlines the successful management of a mid-shaft humerus fracture with radial nerve palsy in a 53-year-old male involved in a road traffic accident. The patient underwent open reduction and internal fixation (ORIF) using plate osteosynthesis with radial nerve exploration. Postoperatively, a tailored physical therapy regimen was implemented, focusing on early range of motion (ROM) exercises, strengthening, and pain management through cryotherapy. A cock-up splint was used for wrist drop caused by radial nerve damage. Over 12 weeks, the patient demonstrated significant improvements in ROM, muscle strength, and pain levels, as evidenced by outcome measures such as the NPRS, PRWE, and DASH scores. The rehabilitation included proprioceptive neuromuscular facilitation, sensory intrigation and advanced tools like a robotic glove to optimize recovery. This case highlights the importance of a multidisciplinary approach, combining timely surgical intervention with structured rehabilitation to achieve functional recovery and independence in daily activities. The use of modern rehabilitation technologies like robotic gloves shows promise in enhancing outcomes for complex upper limb injuries.