Radial nerve palsy | Page 9

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
Masahiro Nishimura, Toshiro Itsubo, Emiko Horii, Masanori Hayashi, Shigeharu Uchiyama, Hiroyuki Kato
Dislocation of the radial head is often encountered as a result of a pediatric Monteggia fracture. We report two rare cases of tardy ulnar nerve palsy associated with anterior radial head dislocation combined with anterior bowing of the ulna. They had cubitus valgus deformity, valgus instability, and osteoarthritis of the elbow, and had elbow injury more than 40 years back. They were diagnosed with chronic radial head dislocation long after a Bado type 1 Monteggia fracture. Anterior subcutaneous ulnar nerve transposition yielded favorable results...
September 2016: Journal of Pediatric Orthopedics. Part B
Eman M Khedr, Gharib Fawi, Mohammed Abd Allah Abbas, Noha Abo El-Fetoh, Ahmed F Zaki, Ayman Gamea
BACKGROUND: No epidemiological studies on the prevalence of compressive neuropathy have been undertaken in Arab countries. The aim of the study was to estimate the prevalence of the most common types of compressive neuropathies in Qena governorate/Egypt. METHODS: The study was part of a community-based survey carried out to assess the prevalence of neuromuscular disorders among the Qena population. A random sampling of 10 districts, 5,039 inhabitants aged ≥20...
2016: Neuroepidemiology
A Wenger, J Berger, H Piza-Katzer
BACKGROUND: Supracondylar humerus fractures are very common in pediatric populations. In cases of dislocated fractures, closed reduction and percutaneous K‑wire fixation is recommended. Initially, 10-16 % of the patients also present lesion of the ulnar nerve as well as median nerve palsy in 6.4% and radial nerve palsy in 2.6 % of cases, respectively. METHOD: We present the case of a 10-year-old boy with a dislocation of the elbow and fracture of the medial epicondyle...
August 2016: Der Unfallchirurg
Abdulla Aljawder, Mohammed Khalid Faqi, Abeer Mohamed, Fahad Alkhalifa
INTRODUCTION: Anterior Interosseous Nerve (AIN) is a motor branch from the Median nerve and runs deep in the forearm along with the anterior interosseous artery. It innervates three muscles in the forearm; an isolated palsy of these muscles is known as AIN Syndrome. There are several documented causes of AIN syndrome but its pathophysiology remains unclear. PRESENTATION OF CASE: A 48-year old male that presented with right elbow pain and inability to flex his right interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger...
2016: International Journal of Surgery Case Reports
Pawel Reichert, Witold Wnukiewicz, Jarosław Witkowski, Aneta Bocheńska, Sylwia Mizia, Jerzy Gosk, Krzysztof Zimmer
BACKGROUND The aim of this study was to analyze the causes that lead to secondary damage of the radial nerve and to discuss the results of reconstructive treatment. MATERIAL AND METHODS The study group consisted of 33 patients treated for radial nerve palsy after humeral fractures. Patients were diagnosed based on clinical examinations, ultrasonography, electromyography, or nerve conduction velocity. During each operation, the location and type of nerve damage were analyzed. During the reconstructive treatment, neurolysis, direct neurorrhaphy, or reconstruction with a sural nerve graft was used...
February 19, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Mohsen Mardani Kivi, Mehran Soleymanha, Zahra Haghparast-Ghadim-Limudahi
BACKGROUND: The aim of this study was to determine the treatment outcome of humeral shaft fractures with a locked rigid intramedullary nail in patients indicated for surgical treatment. METHODS: In this descriptive-cross sectional study, all patients were followed up for one, six, and 18 months post operatively. The Short Form Questionnaire (SF-36) and Constant Shoulder Score were applied. RESULTS: Of 78 included patients (mean age: 35), one patient had a soft tissue infection, one had secondary radial nerve palsy, eight had non-union, one had elbow limited range of motion in extension, and three patients had decreased shoulder range of motion...
January 2016: Archives of Bone and Joint Surgery
Ali Çağdaş Yörükoğlu, A Fahir Demirkan, Nihal Büker, Alp Akman, Nusret Ok
OBJECTIVES: This study aims to present the results of early nerve explorations in cases with radial nerve palsy associated with humeral shaft fracture and to investigate in which cases early nerve explorations may be beneficial. PATIENTS AND METHODS: Twenty-four patients (17 males, 7 females; mean age 36 years; range 18 to 72 years) with complete sensory and motor radial nerve damage associated with humeral shaft fracture were retrospectively analyzed. The patients with high-energy trauma and the ones who had spiral and segmental fractures with low energy traumas were included in the study...
2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Tongjoo Lee, Jaesik Yoon
PURPOSE: Open reductions and internal fixations are currently being used the most in surgeries of humeral shaft fractures. However, there are some limitations such as invasive techniques and formation of many operation scars. To overcome these limitations, a minimally invasive plate osteosynthesis has been recently introduced. However, this has technical limitations such as deep dissections of the distal portion and narrowness of the fixation space. To address these problems, we designed another introductory technique of a minimally invasive osteosynthesis and we have examined the clinical usefulness of that...
December 2016: International Orthopaedics
Zhongyu Li, Michael Reynolds, Ellen Satteson, Omar Nazir, James Petit, Beth P Smith
PURPOSE: To evaluate outcomes following transfer of the supinator motor branch of the radial nerve (SMB) to the posterior interosseous nerve (PIN) and the pronator teres motor branch of median (PTMB) to the anterior interosseous nerve (AIN) in patients with lower brachial plexus injuries. METHODS: Since December 2010, 4 patients have undergone combined transfer of the SMB to PIN and PTMB to AIN for lower brachial plexus palsies. The study was prospectively designed, and the patients were followed for 4 years to monitor their functional improvement...
April 2016: Journal of Hand Surgery
Michael A Kuhne, Darin Friess
The radial nerve is at risk of injury during surgical approaches to the humeral shaft. Previous authors have described an anterolateral approach to the humerus limited by the radial nerve, requiring that distal dissection be carried anterior into a neurovascularly crowded interval. A novel extensile approach is described using a neuromuscular bridge to protect the radial nerve, thus enabling safe distal extension of the anterolateral humerus approach. The authors present a case series of 7 patients who required an extensile humeral exposure...
January 2016: Orthopedics
Ajeesh Sankaran, Ankit Thora, Sumit Arora, Anil Dhal
PURPOSE: To evaluate the outcome after single tendon transfer of the flexor carpi ulnaris (FCU) to the digital extensors for high radial nerve palsy. METHODS: Records of 10 patients aged 16 to 43 (median, 27) years who underwent single tendon transfer of the FCU to the digital extensors for high radial nerve palsy secondary to closed (n=4) or open (n=4) diaphyseal humeral fractures or deltoid injection (n=2) were reviewed. Two of the patients with open fractures also underwent treatment for non-union in a staged manner...
December 2015: Journal of Orthopaedic Surgery
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