+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Combined median and ulnar nerve palsy complicating distal radius fractures

Combined median and ulnar nerve palsy complicating distal radius fractures

Orthopaedics and Traumatology, Surgery and Research 104(6): 871-875

Fractures of the distal radius only rarely give rise to complications in the immediate postoperative period. Combined median and ulnar nerve palsy is a complication that can be missed by the surgeon. Three cases diagnosed early after surgery are reported here. The patients were 15, 16, and 30 years of age, respectively. None had preoperative neurological deficits. The youngest patient was injured during sports and the other 2 patients during traffic accidents. All 3 patients had a displaced fracture of the distal radius combined with a fracture of the distal fourth of the ulna or ulnar styloid process and were treated by anterior plate fixation. Operative times were 47, 62, and 120minutes, respectively. Compartment syndrome was ruled out based on low pain intensity and absence of forearm tightness to palpation. The electrophysiological study performed 1 month post-injury in all 3 patients showed severe impairments of both median and ulnar nerve function. Median and ulnar nerve release surgery was performed in the 15-year-old 6 weeks post-injury. No nerve damage or fibrosis was seen during the procedure. All patients recovered fully within 3 months and had normal findings from follow-up electrophysiology testing after 6 months. Combined median and ulnar nerve palsy has rarely been reported and is among the rare complications of distal radial fractures that can develop in the event of a high-energy trauma and/or major displacement. Both previously published data and our experience indicate that surgical nerve release is unnecessary. Clinical recovery within 3 months is the rule. IV, case-reports.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 055350102

Download citation: RISBibTeXText

PMID: 29969720

DOI: 10.1016/j.otsr.2018.04.026

Related references

Combined median and ulnar nerve lesions complicating fractures of the distal radius and ulna. Two case reports. Journal of Trauma 8(6): 1114-1118, 1968

Ulnar nerve palsy following fractures of the distal radius: clinical and anatomical studies. Journal of Hand Surgery 16(4): 438-440, 1991

Ulnar nerve palsy associated with fracture of the distal radius. Journal of Orthopaedic Trauma 21(2): 113-116, 2007

Fracture of the distal radius with ulnar nerve palsy. Journal of Trauma 18(4): 278-279, 1978

Ulnar nerve palsy following closed fracture of the distal radius: a report of 2 cases. Clinics in Orthopedic Surgery 2(1): 55-58, 2011

Ulnar nerve palsy following fracture of the distal radius in an adolescent: a case report. Kaohsiung Journal of Medical Sciences 23(3): 151-155, 2007

Median Nerve Injuries Associated With Distal Radius Fractures. Techniques in Orthopaedics 21(1): 48-53, 2006

Peripheral nerve palsy in fractures of the distal radius. Orthopedic Surgery 41(4): 521-524, 1990

Measurement of ulnar variance and radial inclination on X-rays of healed distal radius fractures. With the axis of the distal radius or ulna?. Acta Orthopaedica Belgica 81(2): 308-314, 2015

Lesions of the distal radio-ulnar joint in compression-extension fractures of the distal extremity of the radius. Six cases with associated anterior dislocation of the ulnar head. Annales de Chirurgie de la Main et du Membre Superieur 11(2): 97-106, 1992

Excision Of Brachial Portion Of Ulnar Nerve For Multiple Neuro-Fibromata, With Reciprocal Grafting Of The Ulnar Nerve Into The Median Nerve, And Of A Portion Of The Median Into The Ulnar; Hyperalgesia Of Median Area; Mechanism; Paroxysmal Neural Pains. The Journal of Nervous and Mental Disease 43(2): 153-155, 1916

Symptoms of the compression of median nerve in patients after fractures of the distal radius treated operatively. Chirurgia Narzadow Ruchu i Ortopedia Polska 76(4): 189-192, 2012

Treatment of interphalangeal hyperflexion and metacarpophalangeal hyperextension of the thumb in combined low median-ulnar nerve palsy. Journal of Hand Surgery 23(6): 1059-1062, 1998

Prognostic factors for outcome after median, ulnar, and combined median-ulnar nerve injuries: a prospective study. Journal of Plastic, Reconstructive and Aesthetic Surgery 68(1): 1-8, 2015

Median, ulnar, and combined median-ulnar nerve injuries: functional outcome and return to productivity. Journal of Trauma 51(4): 687-692, 2001