# Radiolucent cerclage for humerus fractures: beware of radial nerve injury—a case report

## TL;DR

A 73-year-old woman developed radial nerve injury after a humerus fracture surgery using radiolucent cerclage, highlighting risks and anatomical concerns.

## Contribution

The paper highlights the risk of radial nerve injury from radiolucent cerclage in humerus fracture surgeries and identifies high-risk anatomical zones.

## Key findings

- Radial nerve injury occurred due to compression from radiolucent cerclage in a proximal humerus fracture case.
- Modern radiolucent cerclage systems can exert high loads but pose neurological risks if not used safely.
- Delayed diagnosis and treatment of nerve injuries can lead to debilitating outcomes.

## Abstract

A 73-year-old woman was referred to a National Centre for Peripheral Nerve Injury with a post-operative left radial nerve degenerative lesion following open reduction and internal fixation of a proximal third humerus fracture using radiolucent Arthrex FiberTape® Cerclage as an adjunct to plating to improve stability. Intra-operative photographs illustrate compression of the radial nerve under the cerclage construct. Use of radiolucent cerclage for humerus fractures is increasing with modern systems capable of withstanding an ultimate load of 4300 N. We highlight the risk of debilitating neurological injury when not deployed safely and describe anatomical high-risk zones for injury. We emphasize the impact of delay in diagnosis and treatment.