Radial nerve palsy | Page 8

A Maresca, R Fantasia, M Cianforlini, N Giampaolini, S Cerbasi, R Pascarella
PURPOSE: Distal-third diaphyseal fractures of the humerus are often hard to treat due to location and pattern of the fractures, radial nerve injury, and quality of bone and age of patients. The aim of this retrospective study is to propose the best approach and the best surgical technique according to the pattern of extra-articular fracture of the distal humerus. METHODS: We have treated 37 fractures of the distal humerus between January 2010 and July 2015 classified according to the AO classification...
December 2016: Musculoskeletal Surgery
Roger D M Walton, Neal M Ormsby, Steven D Brookes-Fazakerley, Shambavi Manohar, Trupesh Patel, David M Wright, Alf A Bass, Colin E Bruce
Paediatric Monteggia-type injuries are complicated by treatment failure and posterior interosseous nerve palsy, without reliable predictive indicators. Outcome is considered to be good, with little patient-reported evidence. We propose novel radiographic parameters. A total of 33 Monteggia-type injuries were analysed. Posterior interosseous nerve palsy was strongly predicted by the Radial Head Displacement Index. The presence of two or more of three novel instability markers was associated strongly with treatment failure...
January 2017: Journal of Pediatric Orthopedics. Part B
Hassan Tahir, Vistasp Daruwalla, Jeremy Meisel, Samir E Kodsi
Pseudoperipheral palsy has been used to characterize isolated monoparesis secondary to stroke. Isolated hand nerve palsy is a rare presentation for acute cerebral stroke. Our patient presented with clinical features of typical peripheral radial nerve palsy and a normal computed tomography scan of the head, which, without a detailed history and neurological examination, could have been easily misdiagnosed as a peripheral nerve lesion deferring further investigation for a stroke. We stress the importance of including cerebral infarction as a critical differential diagnosis in patients presenting with sensory-motor deficit in an isolated peripheral nerve pattern...
July 2016: Journal of Investigative Medicine High Impact Case Reports
Cong Xiao, Fan Tang, Yong Zhou, Wenli Zhang, Yi Luo, Hong Duan, Chongqi Tu
BACKGROUND: Infected nonunion of the humeral diaphysis is a challenging problem for orthopedic surgeons. This study aimed to evaluate the outcome of using a locking compression plate (LCP) as a definitive external fixator in the management of infected nonunion of the humeral diaphysis after failure of internal fixation. METHODS: We retrospectively reviewed a series of seven patients with infected nonunion of the humeral diaphysis treated with an LCP as an external fixator between June 2010 and August 2014...
August 5, 2016: BMC Surgery
Morgan Jones, Hean Wu Kang, Christopher O'Neill, Paul Maginn
Radial nerve injury is a recognised complication associated with humeral shaft fracture. A case of iatrogenic radial nerve injury is presented following fracture reduction. The relevant anatomy, challenges in management of humeral fractures with associated radial nerve injury, and the importance of detailed clinical assessment and documentation are discussed.
2016: Case Reports in Emergency Medicine
Jonathan Isaacs, Obinna Ugwu-Oju
The median nerve serves a crucial role in extrinsic and intrinsic motor and sensory function to the radial half of the hand. High median nerve injuries, defined as injuries proximal to the anterior interosseous nerve origin, therefore typically result in significant functional loss prompting aggressive surgical management. Even with appropriate recognition and contemporary nerve reconstruction, however, motor and sensory recovery may be inadequate. With isolated persistent high median nerve palsies, a variety of available tendon transfers can improve key motor functions and salvage acceptable use of the hand...
August 2016: Hand Clinics
Andre Eu-Jin Cheah, Jennifer Etcheson, Jeffrey Yao
Radial nerve palsy typically occurs as a result of trauma or iatrogenic injury and leads to the loss of wrist extension, finger extension, thumb extension, and a reduction in grip strength. In the absence of nerve recovery, reconstruction of motor function involves tendon transfer surgery. The most common donor tendons include the pronator teres, wrist flexors, and finger flexors. The type of tendon transfer is classified based on the donor for the extensor digitorum communis. Good outcomes have been reported for most methods of radial nerve tendon transfers as is typical for positional tendon transfers not requiring significant power...
August 2016: Hand Clinics
Lei Zhang, Zhen Dong, Chun-Lin Zhang, Yu-Dong Gu
Background  C7 - T1 palsy results in complete loss of finger motion and poses a surgical challenge. This study investigated the anatomy of the radial nerve in the elbow and forearm and the feasibility of intraplexus nerve transfer to restore thumb and finger extension. Methods  The radial nerves were dissected in 28 formalin-fixed upper extremities. Branching pattern, length, diameter, and number of myelinated fibers were recorded. Results  Commonly, the branching pattern (from proximal to distal) was to the brachioradialis, extensor carpi radialis longus, superficial sensory proximal to the lateral epicondyle, extensor carpi radialis brevis, supinator, extensor digitorum communis, extensor digiti minimi, extensor carpi ulnaris, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, and extensor indicis distal to the lateral epicondyle...
November 2016: Journal of Reconstructive Microsurgery
I H Y Kwok, Z M Silk, T J Quick, M Sinisi, A MacQuillan, M Fox
AIMS: We aimed to identify the pattern of nerve injury associated with paediatric supracondylar fractures of the humerus. PATIENTS AND METHODS: Over a 17 year period, between 1996 and 2012, 166 children were referred to our specialist peripheral nerve injury unit. From examination of the medical records and radiographs were recorded the nature of the fracture, associated vascular and neurological injury, treatment provided and clinical course. RESULTS: Of the 166 patients (111 male, 55 female; mean age at time of injury was seven years (standard deviation 2...
June 2016: Bone & Joint Journal
Hiroshi Satake, Naomi Hanaka, Ryusuke Honma, Tadayoshi Watanabe, Shigeru Inoue, Yumiko Kanauchi, Yoshihiro Kato, Taku Nakajima, Daisuke Sato, Jun Eto, Masahiro Maruyama, Yasushi Naganuma, Junya Sasaki, Shuji Toyono, Mikio Harada, Daisuke Ishigaki, Masatoshi Takahara, Michiaki Takagi
The current study investigated the incidence of complications after surgery for distal radial fractures. This multicenter retrospective study was conducted at 11 institutions. A total of 824 patients who had distal radius fractures that were treated surgically between January 2010 and August 2012 were identified. The study patients were older than 18 years and were observed for at least 12 weeks after surgery for distal radius fractures with a volar locking plate. Sex, age, fracture type according to AO classification, implants, wrist range of motion, grip strength, fracture consolidation rate, and complications were studied...
September 1, 2016: Orthopedics
Michael A Behun, Andrew G Geeslin, Emma C O'Hagan, Jeffrey C King
PURPOSE: To systematically review the literature regarding surgical outcomes for treatment of partial tears of the distal biceps brachii tendon. METHODS: This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. A systematic review of the literature regarding treatment of partial tears of the distal biceps tendon was conducted using PubMed, Embase, and Cochrane. Inclusion criteria consisted of studies in the English language on the treatment of partial distal biceps tendon tears...
July 2016: Journal of Hand Surgery
Pietro Poglia, Laurent Wehrli, Sylvain Steinmetz, Philippe Zermatten
BACKGROUND: The combination of an elbow dislocation, a radial head fracture, and a coronoid process fracture is known as "terrible triad" injury of the elbow. This injury is one of the most challenging injuries of the musculoskeletal system and almost always causes instability of the elbow. The use of an adjuvant hinged external fixator in such injuries is still debated. CASE PRESENTATION: In this case report we present a case of radial nerve palsy after setting up an adjuvant hinged external fixator in a complex fracture-dislocation of the elbow...
May 11, 2016: Journal of Medical Case Reports
Xuqi Hu, Siqi Xu, Huigen Lu, Bao Chen, Xiao Zhou, Xiaojun He, Jiaping Dai, Zhongwei Zhang, Suiliang Gong
BACKGROUND: In this study, we performed a meta-analysis to identify whether minimally invasive plate osteosynthesis (MIPO) was superior to conventional fixation techniques (CFT) for treating humeral shaft fractures. METHODS: A systematic literature search was conducted up to February 2016 in ScienceDirect, Springer, MEDLINE, and PubMed databases for relevant papers that compared the outcomes of MIPO with CFT, such as open reduction with plate osteosynthesis (ORPO) and intramedullary nail (IMN) for treating humeral shaft fractures...
May 11, 2016: Journal of Orthopaedic Surgery and Research
Edward Westrick, Benjamin Hamilton, Paul Toogood, Bradford Henley, Reza Firoozabadi
PURPOSE: There has been little direct comparison between non-operative and operative management of humeral shaft fractures. The present study aimed to compare union rates and complication rates between these two modalities of treatment. METHODS: A retrospective cohort study was performed at a regional level 1 trauma centre. A total of 296 patients with humeral shaft fractures met inclusion criteria; 69 patients were treated with a functional brace and 227 with surgical intervention...
February 2017: International Orthopaedics
R Colasanti, M Iacoangeli, A Di Rienzo, M Dobran, L Di Somma, N Nocchi, M Scerrati
BACKGROUND: Posterior interosseous nerve (PIN) palsy may present with various symptoms, and may resemble cervical spondylosis. CASE REPORT: We report about a 59-year-old patient with cervical spondylosis which delayed the diagnosis of posterior interosseous nerve (PIN) palsy due to an intermuscular lipoma. Initial right hand paraesthesias and clumsiness, together with MR findings of right C5-C6 and C6-C7 foraminal stenosis, misled the diagnostic investigation. The progressive loss of extension of all right hand fingers brought to detect a painless mass compressing the PIN...
January 2016: Il Giornale di Chirurgia
Takehiko Takagi, Atsuhito Seki, Shinichiro Takayama, Masahiko Watanabe, Joji Mochida
We reviewed the outcomes of post-traumatic varus deformity treated with modified step-cut osteotomy in 19 patients (average age, 7.4 years; range, 4.3-16.8 years at time of surgery). The average follow-up period was 29.6 months. The mean range of motion was 15.0°/124.7° (extension/flexion) before surgery and 6.8°/132.6° at final follow-up. The humerus-elbow-wrist angle was -21.1° before surgery and 4.2° at final follow-up, with a loss of 4.4° from the value of the humerus-elbow-wrist angle after the surgery...
September 2016: Journal of Pediatric Orthopedics. Part B
Rafael Kakazu, Steven K Dailey, Amanda J Schroeder, John D Wyrick, Michael T Archdeacon
OBJECTIVES: To determine the rate of iatrogenic radial nerve palsy (RNP) after surgical repair of established humeral shaft nonunion (HSNU). DESIGN: Retrospective chart review. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: Fifty-four patients with HSNU, 10 (18.5%) of whom developed an iatrogenic RNP after nonunion repair. INTERVENTION: HSNU repair with compression plate stabilization with or without autogenous bone graft...
May 2016: Journal of Orthopaedic Trauma
Mitchell A Pet, Angelo B Lipira, Jason H Ko
High radial nerve injury is a common pattern of peripheral nerve injury most often associated with orthopedic trauma. Nerve transfers to the wrist and finger extensors, often from the median nerve, offer several advantages when compared to nerve repair or grafting and tendon transfer. In this article, we discuss the forearm anatomy pertinent to performing these nerve transfers and review the literature surrounding nerve transfers for wrist, finger, and thumb extension. A suggested algorithm for management of acute traumatic high radial nerve palsy is offered, and our preferred surgical technique for treatment of high radial nerve palsy is provided...
May 2016: Hand Clinics
Nikolaus Wilhelm Lang, Roman Christian Ostermann, Cathrin Arthold, Julian Joestl, Patrick Platzer
PURPOSE: The purpose of this study was to assess recovery and clinical outcome in patients with primary or secondary radial nerve palsy following humeral shaft fracture. METHODS: We retrospectively assessed 102 patients (45 female and 57 male) with humeral shaft fracture and concomitant radial nerve palsy, who were followed up for 12 months. Patients were divided into two groups with primary or secondary radial nerve palsy depending on the onset. Muscle function was measured according to Daniels classification and degree of nerve damage was assessed by the Sunderland classification...
January 2017: International Orthopaedics
Shizhan Wei, Yujin Tang, Peng Weibo, Huadeng Ban
OBJECTIVE: To investigate the effectiveness of a modified surgical treatment of old Monteggia fracture. METHODS: Between March 2006 and December 2013, 40 cases of old Monteggia fracture were treated with modified operation. Modified operation procedure included expanding excision of pedicled forearm fascia flap for reconstruction of the annular ligament and repair of elbow radial lateral collateral ligament complex and extending osteotomy of the ulna, callus replantation, and internal fixation with steel plate...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
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