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1.
Rev. medica electron ; 43(5): 1445-1455, 2021. graf
Article in Spanish | LILACS | ID: biblio-1352124

ABSTRACT

RESUMEN La parálisis del nervio radial producida por lesiones a nivel del brazo es considerada una parálisis alta, y se caracteriza por presentar la muñeca y los dedos flexionados y el pulgar en aducción con imposibilidad para la extensión de los mismos (muñeca y dedos). Todos los autores coinciden en que, para la extensión de la muñeca, el músculo de elección a transferir es el pronador redondo para el segundo radial. Sin embargo, hay diversidad de criterios sobre la utilización del palmar mayor o del cubital anterior para el extensor común de los dedos, y del palmar menor para el extensor largo del pulgar. Se presentó el caso de un paciente de 31 años de edad, con antecedente de accidente de tránsito y diagnóstico de parálisis radial alta de 18 meses de evolución, en el que se decide tratamiento quirúrgico utilizando el músculo cubital anterior después de una rehabilitación exitosa, obteniéndose excelentes resultados (AU).


ABSTRACT The radial nerve paralysis produced by lesions at the level of the arm is considered a high paralysis, and is characterized by presenting the wrist and fingers flexed and the thumb in adduction with impossibility of extending them (wrist and fingers). All consulted authors agree that, for wrist extension, the elective muscle to transfer is the round pronator for the second radial. However, there are different criteria on the use of the palmar major or anterior ulnar for the common finger extender, and the palmar minor for the long thumb extender. We presented the case of a 31-year-old patient, with a history of traffic accident and diagnosis of 18-month high radial paralysis, in which surgical treatment using the anterior ulnar muscle after a successful rehabilitation was decided, obtaining excellent results (AU).


Subject(s)
Humans , Male , Tendon Transfer/methods , Radial Neuropathy/surgery , Quality of Life , Surgical Procedures, Operative/methods , Tendon Transfer/rehabilitation , Radial Neuropathy/diagnosis
3.
Rev. méd. Maule ; 36(2): 34-43, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1344612

ABSTRACT

Pain located in the lateral aspect of the elbow is a common cause of consultation in the trauma consultation. The most common cause is "lateral epicondylitis," however there are several differential diagnoses that may require different management. There is a case of radial tunnel syndrome secondary to extrinsic compression, with an emphasis on its diagnosis and surgical technique.


Subject(s)
Humans , Male , Middle Aged , Carpal Tunnel Syndrome/diagnosis , Radial Neuropathy/surgery , Radial Neuropathy/diagnosis , Nerve Compression Syndromes , Radial Nerve , Synovial Cyst/surgery , Magnetic Resonance Imaging , Combined Modality Therapy , Elbow , Elbow Joint , Pain Management , Injections, Intra-Articular , Neurologic Examination/methods
4.
Rev. bras. ortop ; 55(1): 27-32, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1092685

ABSTRACT

Abstract Objective The purpose of the present study was to analyze the structures in the radial tunnel that can cause posterior interosseous nerve entrapment. Methods A total of 30 members of 15 adult cadavers prepared by intra-arterial injection of a 10% solution of glycerol and formalin were dissected. All were male, belonging to the laboratory of anatomy of this institution. Results The branch for the supinator muscle originated from the posterior interosseous nerve in all limbs. We identified the Frohse arcade with a well-developed fibrous constitution in 22 of the 30 dissected limbs (73%) and of muscular constitution in 8 (27%). The distal margin of the supinator muscle presented fibrous consistency in 7 of the 30 limbs (23.5%) and muscular appearance in 23 (76.5%). In the proximal margin of the extensor carpi radialis brevis muscle, we identified the fibrous arch in 18 limbs (60%); in 9 (30%) we noticed the arcade of muscular constitution; in 3 (10%) there was only the radial insertion, so that it did not form the arcade. Conclusion The Frohse arcade and the arcade formed by the origins of the extensor carpi radialis brevis are normal anatomical structures in adult cadavers. However, from the clinical point of view, these structures have the potential to cause entrapment of the posterior interosseous nerve.


Resumo Objetivo O objetivo do presente estudo foi analisar as estruturas contidas no túnel radial que podem causar neuropatia compressiva do nervo interósseo posterior. Métodos Foram dissecados 30 membros de 15 cadáveres adultos, preparados por injeção intra-arterial de uma solução de glicerina e formol a 10%. Todos do sexo masculino, pertencentes ao laboratório de anatomia desta instituição. Resultados O ramo para o músculo supinador originou-se do nervo interósseo posterior em todos os membros. Identificamos a arcada de Frohse com uma constituição fibrosa bem desenvolvida em 22 dos 30 membros dissecados (73%) e de constituição muscular em 8 (23%) A margem distal do músculo supinador apresentou consistência fibrosa em 7 dos 30 membros (23,5%) e uma aparência muscular em 23 (76,5%). Na margem proximal do músculo extensor radial curto do carpo, identificamos a arcada fibrosa em 18 membros (60%); em 9 (30%), notamos a arcada de constituição muscular; e em três (10%) havia apenas a inserção radial, de maneira que não formava a arcada. Conclusão A arcada de Frohse e a arcada formada pelas origens do músculo extensor radial curto do carpo são estruturas anatômicas normais em cadáveres adultos. No entanto, sob o ponto de vista clínico, essas estruturas têm potencial para causar a compressão do nervo interósseo posterior.


Subject(s)
Radial Nerve , Cadaver , Radial Neuropathy , Anatomy , Nerve Compression Syndromes
5.
Article in English | WPRIM | ID: wpr-716538

ABSTRACT

OBJECTIVE: To determine a diagnostic cut-off value for the cross-sectional area (CSA) of the radial nerve using ultrasonography for radial neuropathy located at the spiral groove (SG). METHODS: Seventeen patients with electrodiagnostic evidence of radial neuropathy at the SG and 30 healthy controls underwent ultrasonography of the radial nerve at the SG . The CSAs at the SG were compared in the patient and control groups. The CSA at the SG between the symptomatic and asymptomatic sides (ΔSx–Asx and Sx/Asx, respectively) were analyzed to obtain the optimal cut-off value. The relationship between the electrophysiological severity of radial neuropathy and CSA was also evaluated. RESULTS: Among the variables examined, there were statistically significant differences in the CSA between the patient and control groups, ΔSx–Asx, and Sx/Asx at the SG. In a receiver operating characteristics analysis, the cut-off CSA was 5.75 mm² at the SG (sensitivity 52.9%, specificity 90%), 1.75 mm² for ΔSx–Asx (sensitivity 58.8%, specificity 100%), and 1.22 mm² for Sx/Asx (sensitivity 70.6%, specificity 93.3%) in diagnosing radial neuropathy at the SG. There was no significant correlation between CSA and electrophysiological severity score for either patient group. CONCLUSION: The reference value obtained for CSA of the radial nerve at the SG may facilitate investigation of radial nerve pathologies at the SG.


Subject(s)
Diagnostic Imaging , Humans , Pathology , Radial Nerve , Radial Neuropathy , Reference Values , ROC Curve , Sensitivity and Specificity , Ultrasonography
6.
Article in Korean | WPRIM | ID: wpr-105736

ABSTRACT

Cryolipolysis has become available for the noninvasive reduction of adipose tissue. A 33-year-old woman presented with wrist drop of the right arm that had first appeared 7 days previously. She had undergone cryolipolysis on both upper arms immediately prior to the onset of symptoms. A nerve conduction study showed radial neuropathy proximal to the elbow, and ultrasonography revealed focal swelling of the radial nerve at the spiral groove. Although cryolipolysis has been known as a safe method, nerve injury can result from compression and/or hypothermia during the procedure.


Subject(s)
Adipose Tissue , Adult , Arm , Elbow , Female , Humans , Hypothermia , Lipolysis , Methods , Neural Conduction , Radial Nerve , Radial Neuropathy , Ultrasonography , Wrist
7.
Article in English | WPRIM | ID: wpr-28780

ABSTRACT

The reported cases of upper limb nerve injury followed by needle procedure such as intramuscular injection or routine venipuncture are rare. However, it should not be overlooked, because neurological injury may cause not only minor transient pain but also severe sensory disturbance, hand deformity and motor dysfunction with poor recovery. Recognizing competent level of anatomy and adept skill of needle placement are crucial in order to prevent this complication. If a patient notices any experience of abnormal pain or paresthesia during the needle procedures, an administrator should be alert to the possibility of nerve injury and should withdraw the needle immediately. Careful monitoring of the injection site for hours is required for early detection of nerve injury.


Subject(s)
Administrative Personnel , Catheterization, Peripheral , Hand Deformities , Humans , Injections, Intramuscular , Median Neuropathy , Needles , Paresthesia , Peripheral Nerve Injuries , Phlebotomy , Radial Neuropathy , Ulnar Neuropathies , Upper Extremity
8.
Article in Korean | WPRIM | ID: wpr-158099

ABSTRACT

Radial nerve entrapment or compression in the upper extremity is relatively rare compared to medial nerve or ulnar nerve entrapment and compression. Various syndrome types are defined according to the location of radial nerve entrapment and the pattern of symptom expression. In the upper arm, Saturday night palsy or honeymoon palsy occurs. Around the elbow, posterior interosseous nerve entrapment syndrome, which involves pure motor symptoms, and radial tunnel syndrome, which mainly involves pain symptoms, can develop. Finally, superficial radial nerve entrapment occurs in the distal forearm and has the symptom of painful or abnormal sensory disturbances of the hand. Conservative treatment is usually the first choice for radial nerve neuropathy, unless there is motor paralysis. Surgical treatment can be considered if there is no improvement after adequate conservative treatment.


Subject(s)
Arm , Elbow , Forearm , Hand , Nerve Compression Syndromes , Paralysis , Radial Nerve , Radial Neuropathy , Ulnar Nerve Compression Syndromes , Upper Extremity
9.
Article in English | WPRIM | ID: wpr-93263

ABSTRACT

Among autologous breast reconstruction techniques, breast reconstruction using the latissimus dorsi musculocutaneous flap is widely used, offering advantages including the relative simplicity of the procedure and the reliable and consistent vascularity of the flap. Accordingly, more than 500 cases have been performed in the past 8 years at Kyungpook National University Medical Center. This study reports on a rare case involving a radial nerve neuropathy complication which was experienced for the first time at the medical center. The current case demonstrates that in addition to common complications, such as seroma of the donor site and scarring, additional intraoperative complications in areas unrelated to the surgical site can occur, including radial nerve neuropathy in the opposite arm.


Subject(s)
Academic Medical Centers , Arm , Breast , Cicatrix , Female , Humans , Intraoperative Complications , Mammaplasty , Myocutaneous Flap , Paralysis , Radial Nerve , Radial Neuropathy , Seroma , Superficial Back Muscles , Tissue Donors
10.
Chinese Journal of Traumatology ; (6): 217-220, 2016.
Article in English | WPRIM | ID: wpr-235744

ABSTRACT

<p><b>PURPOSE</b>Fractures of the humeral shaft are common and account for 3%-5% of all orthopedic injuries. This study aims to estimate the incidence of radial nerve palsy and its outcome when the anterior approach is employed and to analyze the predictive factors.</p><p><b>METHODS</b>The study was performed in the department of orthopaedics unit of a tertiary care trauma referral center. Patients who underwent surgery for acute fractures and nonunions of humerus shaft through an anterior approach from January 2007 to December 2012 were included. We retrospectively analyzed medical records, including radiographs and discharge summaries, demographic data, surgical procedures prior to our index surgery, AO fracture type and level of fracture or nonunion, experience of the operating surgeon, time of the day when surgery was performed, and radial nerve palsy with its recovery condition. The level of humerus shaft fracture or nonunion was divided into upper third, middle third and lower third. Irrespective of prior surgeries done elsewhere, the first surgery done in our institute through an anterior approach was considered as the index surgery and subsequent surgical exposures were considered as secondary procedures.</p><p><b>RESULTS</b>Of 85 patients included, 19 had preoperative radial nerve palsy. Eleven (16%) patients developed radial nerve palsy after our index procedure. Surgeons who have two or less than two years of surgical experience were 9.2 times more likely to induce radial nerve palsy (p=0.002). Patients who had surgery between 8 p.m. and 8 a.m. were about 8 times more likely to have palsy (p=0.004). The rest risk factor is AO type A fractures, whose incidence of radial nerve palsy was 1.3 times as compared with type B fractures (p =0.338). For all the 11 patients, one was lost to follow-up and the others recovered within 6 months.</p><p><b>CONCLUSION</b>Contrary to our expectations, secondary procedures and prior multiple surgeries with failed implants and poor soft tissue were not predictive factors of postoperative deficit. From our study, we also conclude that radial nerve recovery can be reasonably expected in all patients with a postoperative palsy following the anterolateral approach.</p>


Subject(s)
Adult , Female , Fractures, Ununited , General Surgery , Humans , Humeral Fractures , General Surgery , Incidence , Male , Postoperative Complications , Epidemiology , Radial Neuropathy , Epidemiology , Retrospective Studies
11.
Article in English | WPRIM | ID: wpr-289860

ABSTRACT

Objective To evaluate the diagnostic value of high-frequency ultrasound in the diagnosis of supinator syndrome (SD). Methods Ten patients with supinator syndrome (SD group) and 20 healthy volunteers (control group) underwent ultrasonographic examination. Axial and long-axis views of the radial nerve were taken where the nerves enters the supinator muscle entrance. The maximum transverse diameter and anteroposterior diameter were also measured. Results High-frequency ultrasound clearly revealed the images and course of radial nerve deep branch in two groups. The SD group had swollen nerves and the maximum transverse diameter and anteroposterior diameter were (3.50?0.39)mm and (4.30?0.47)mm,respectively,which were significantly larger than in the control group [(1.10?0.17)mm,t=-29.67,P=0.00;(1.00?0.16)mm,t=-36.72,P=0.00). The causes (including synovial cyst nearby and radial artery recurrent branch) of nerve entrapment were revealed directly in 4 patients in SD group. Conclusions High-frequency ultrasound can clearly display the radial nerve deep branch around the elbow joint. SD patients have swollen nerves at the entrance of the supinator muscle,where the diameters of these nerves are abnormally enlarged.


Subject(s)
Case-Control Studies , Elbow Joint , Diagnostic Imaging , Healthy Volunteers , Humans , Nerve Compression Syndromes , Diagnostic Imaging , Radial Nerve , Diagnostic Imaging , Radial Neuropathy , Diagnostic Imaging , Ultrasonography
12.
Korean Circulation Journal ; : 161-168, 2016.
Article in English | WPRIM | ID: wpr-221731

ABSTRACT

BACKGROUND AND OBJECTIVES: Numbness on the hand occurs infrequently after a transradial cardiac catheterization (TRC). The symptom resembles that of neuropathy. We, therefore, investigated the prevalence, the predicting factors and the presence of neurological abnormalities of numbness, using a nerve conduction study (NCS). SUBJECTS AND METHODS: From April to December 2013, all patients who underwent a TRC were prospectively enrolled. From among these, the patients who experienced numbness on the ipsilateral hand were instructed to describe their symptoms using a visual analogue scale; subsequently, NCSs were performed on these patients. RESULTS: Of the total 479 patients in the study sample, numbness occurred in nine (1.8%) following the procedure. The NCS was performed for eight out of the nine patients, four (50%) of which had an abnormal NCS result at the superficial radial nerve. A larger sheath and history of myocardial infarction (p=0.14 and 0.08 respectively) tended towards the occurrence of numbness; however, only the use of size 7 French sheaths was an independent predictor for the occurrence of numbness (odds ratio: 5.50, 95% confidence interval: 1.06-28.58, p=0.042). The symptoms disappeared for all patients but one, within four months. CONCLUSION: A transient injury of the superficial radial nerve could be one reason for numbness after a TRC. A large sheath size was an independent predictor of numbness; therefore, large sized sheaths should be used with caution when performing a TRC.


Subject(s)
Cardiac Catheterization , Cardiac Catheters , Hand , Humans , Hypesthesia , Myocardial Infarction , Neural Conduction , Prevalence , Prospective Studies , Radial Nerve , Radial Neuropathy
13.
Rev. Asoc. Argent. Ortop. Traumatol ; 80(3): 158-163, sept. 2015.
Article in Spanish | LILACS | ID: lil-768065

ABSTRACT

Introducción: El síndrome del túnel radial es un cuadro que se debe al atrapamiento intermitente del nervio interóseo posterior entre la masa superficial y profunda del músculo supinador corto y estructuras adyacentes, como vasos y fascias. El propósito de este trabajo fue identificar las estructuras anatómicas que producían la eventual compresión, establecer y comunicar las diferencias en cuanto a la percepción subjetiva del dolor antes de la liberación del nervio interóseo posterior en el túnel radial y después de ella. Materiales y Métodos: Entre 2009 y 2014, 17 pacientes fueron sometidos a cirugía mediante liberación del nervio interóseo posterior. Se utilizó la vía de abordaje entre el primer radial externo y el supinador largo. Se evaluó a los pacientes mediante la escala analógica visual para intensidad del dolor antes de la cirugía y a las 6 semanas, y según los criterios funcionales de Roles y Maudsley. Resultados: Las causas de compresión del nervio interóseo posterior fueron: banda fibrosa (arcada de Frõhse) (7 casos), vasos recurrentes (4 casos), compresión por la masa del fascículo superficial del supinador corto (2 casos) y compresión por tendón del segundo radial externo (4 casos). Los resultados fueron excelentes (4 pacientes), buenos (10 pacientes) y regulares (3 pacientes). Los pacientes atendidos a través de la Aseguradora de Riesgos de Trabajo obtuvieron peores resultados que aquellos fuera de este sistema. Conclusiones: El síndrome del túnel radial es una patología que debe ser tenida en cuenta ante un cuadro de epicondilalgia lateral resistente al tratamiento; tiene una incidencia marcada en pacientes con conflicto laboral, lo que puede sesgar el resultado terapéutico final. Nivel de evidencia: IV.


Introduction: Radial tunnel syndrome is a condition secondary to the intermittent entrapment of the posterior interosseous nerve between superficial and deep mass of short supinator adjacent structures, such as vessels and fascias. The purpose of this study was to identify the anatomical structures that produce the eventual compression, to establish and communicate the differences in the subjective pain perception before and after the release of the posterior interosseous nerve in the radial tunnel. Methods: Between 2009 and 2014, 17 patients underwent surgical treatment by posterior interosseous nerve release. We used the approach between the first external radial and brachioradialis. Patients were assessed by visual analogue scale for pain intensity before surgery and at week 6, and according to the Roles and Maudsley functional criteria. Results: The causes of posterior interosseous nerve compression were fibrous band of short supinator (arcade of Frohse) (7 cases), recurrent vessels (4 cases), compression by the mass of the superficial portion of the short supinator muscle (2 cases) and secondary compression by extensor carpi radialis brevis tendon (4 cases). Results were excellent (4 patients), good (10 patients) and fair (3 patients). Patients treated through the Labor Risk Insurance had worse outcomes than those who were not covered by this system. Conclusions: Radial tunnel syndrome is a condition that must be taken into account when there is refractory lateral epicondylalgia. This disease has a marked effect in patients with labor conflict, which may bias the outcome of treatment. Level of evidence: IV.


Subject(s)
Adult , Middle Aged , Elbow Joint/pathology , Decompression, Surgical , Radial Nerve/surgery , Radial Neuropathy/surgery , Radial Neuropathy/diagnosis , Nerve Compression Syndromes/surgery , Nerve Compression Syndromes/diagnosis , Follow-Up Studies , Pain , Treatment Outcome
14.
Article in English | WPRIM | ID: wpr-152499

ABSTRACT

BACKGROUND AND PURPOSE: The objective of this study was to determine diagnostic and prognostic values of proximal radial motor conduction in acute compressive radial neuropathy. METHODS: Thirty-nine consecutive cases of acute compressive radial neuropathy with radial conduction studies-including stimulation at Erb's point-performed within 14 days from clinical onset were reviewed. The radial conduction data of 39 control subjects were used as reference data. RESULTS: Thirty-one men and eight women (age, 45.2+/-12.7 years, mean+/-SD) were enrolled. All 33 patients in whom clinical follow-up data were available experienced complete recovery, with a recovery time of 46.8+/-34.3 days. Partial conduction block was found frequently (17 patients) on radial conduction studies. The decrease in the compound muscle action potential area between the arm and Erb's point was an independent predictor for recovery time. CONCLUSIONS: Proximal radial motor conduction appears to be a useful method for the early detection and prediction of prognosis of acute compressive radial neuropathy.


Subject(s)
Action Potentials , Arm , Diagnosis , Female , Follow-Up Studies , Humans , Male , Prognosis , Radial Neuropathy
16.
Article in English | WPRIM | ID: wpr-39162

ABSTRACT

OBJECTIVE: Posture-induced radial neuropathy, known as Saturday night palsy, occurs because of compression of the radial nerve. The clinical symptoms of radial neuropathy are similar to stroke or a herniated cervical disk, which makes it difficult to diagnose and sometimes leads to inappropriate evaluations. The purpose of our study was to establish the clinical characteristics and diagnostic assessment of compressive radial neuropathy. METHODS: Retrospectively, we reviewed neurophysiologic studies on 25 patients diagnosed with radial nerve palsy, who experienced wrist drop after maintaining a certain posture for an extended period. The neurologic presentations, clinical prognosis, and electrophysiology of the patients were obtained from medical records. RESULTS: Subjects were 19 males and 6 females. The median age at diagnosis was 46 years. The right arm was affected in 13 patients and the left arm in 12 patients. The condition was induced by sleeping with the arms hanging over the armrest of a chair because of drunkenness, sleeping while bending the arm under the pillow, during drinking, and unknown. The most common clinical presentation was a wrist drop and paresthesia on the dorsum of the 1st to 3rd fingers. Improvement began after a mean of 2.4 weeks. Electrophysiologic evaluation was performed after 2 weeks that revealed delayed nerve conduction velocity in all patients. CONCLUSION: Wrist drop is an entrapment syndrome that has a good prognosis within several weeks. Awareness of its clinical characteristics and diagnostic assessment methods may help clinicians make diagnosis of radial neuropathy and exclude irrelevant evaluations.


Subject(s)
Arm , Diagnosis , Drinking , Electrophysiology , Female , Fingers , Humans , Male , Medical Records , Neural Conduction , Paralysis , Parasomnias , Paresthesia , Posture , Prognosis , Radial Nerve , Radial Neuropathy , Retrospective Studies , Stroke , Wrist
17.
Article in English | WPRIM | ID: wpr-7433

ABSTRACT

A 34-year-old male patient visited the emergency room with complaint of right wrist drop and foot drop. The day before, he was intoxicated and fell asleep in a room containing barbeque briquettes; After waking up, he noticed that his right wrist and foot were dropped. Upon physical examination, his right wrist extensor, thumb extensor, ankle dorsiflexor, and big toe extensor showed Medical Research Council (MRC) grade 1 power. The initial laboratory tests suggested rhabdomyolysis induced by unrelieved pressure on the right side during sleep. Right foot drop was improved after conservative care and elevated muscle enzyme became normalized with hydration therapy with no resultant acute renal failure. However, the wrist drop did not show improvement and a hard mass was palpated on the follow-up physical examination. Ultrasonography and magnetic resonance imaging studies were conducted and an abnormal mass in the lateral head of the tricep was detected. Axonopathy was suggested by the electrodiagnostic examination. A surgical decompression was done and a fibrotic cord lesion compressing the radial nerve was detected. After adhesiolysis, his wrist extensor power improved to MRC grade 4. Herein, we describe a compressive radial neuropathy associated with rhabdomyolysis successfully treated with surgery and provide a brief review of the related literature.


Subject(s)
Acute Kidney Injury , Adult , Ankle , Decompression, Surgical , Emergency Service, Hospital , Fibrosis , Follow-Up Studies , Foot , Head , Humans , Magnetic Resonance Imaging , Male , Physical Examination , Radial Nerve , Radial Neuropathy , Rhabdomyolysis , Thumb , Toes , Ultrasonography , Wrist
18.
Chinese Journal of Traumatology ; (6): 175-177, 2014.
Article in English | WPRIM | ID: wpr-358870

ABSTRACT

Neurapraxia frequently occurs following traction injury to the nerve intraoperatively, leading to radial nerve palsy which usually recovers in 5-30 weeks. In our case, we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate. The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal. On the second postoperative day, following the suction drain removal and dressing, patient developed immediate radial nerve palsy along with wrist drop. We reviewed the literature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure.


Subject(s)
Adult , Female , Humans , Humeral Fractures , General Surgery , Postoperative Complications , Radial Neuropathy
20.
Chinese Journal of Traumatology ; (6): 365-367, 2013.
Article in English | WPRIM | ID: wpr-358913

ABSTRACT

Radial nerve palsy is the most common neurological involvement in humeral shaft fractures. But combined radial and median nerve injury in a closed diaphyseal fracture of the humerus is rare. Combined injury to both radial and median nerve can cause significant disability. A detailed clinical examination is therefore necessary following humeral shaft fractures. We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3) together with radial and median nerve palsy, its management and review of the literature. As the patient had two nerves involved, surgical exploration was planned. Fracture was reduced and fixed with a 4.5 mm narrow dynamic compression plate. There was no external injury to both radial and median nerves on surgical exploration. Neurological recovery started at 3 weeks' follow-up. Complete recovery was seen at 12 weeks. Careful clinical examination is of the utmost importance in early diagnosis of combined nerve injuries, which allows better management and rehabilitation of the patient.


Subject(s)
Bone Plates , Humans , Humeral Fractures , General Surgery , Humerus , Median Nerve , Radial Neuropathy
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