Lateral External-fixation Adjacent to Radial Nerve

Plucknette, Benjamin F.; Tennent, David J.; Hsu, Joseph R.; Bates, Taylor; Burns, Travis C.

doi:10.7759/cureus.7435

Cited by 3 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…By using proper antibiotic therapy and wound management, several studies have demonstrated that the risk of infection in intramedullary nailing and external fixation has no difference [ 14 , 15 ]. External fixation could be used as a treatment option for our patient, but the treatment strategy we applied had several advantages; including, better wound management, absence of pin tract infection, and patient comfort [ 16 ]. On the other hand, the safe zone of the proximal pin of external fixator was comminuted in our patient that could fail the successful use of an external fixator [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…External fixation could be used as a treatment option for our patient, but the treatment strategy we applied had several advantages; including, better wound management, absence of pin tract infection, and patient comfort [ 16 ]. On the other hand, the safe zone of the proximal pin of external fixator was comminuted in our patient that could fail the successful use of an external fixator [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Successful treatment of a multifocal comminuted open fracture of humerus with severe soft tissue defect: a case report

Barati

Afzal

2023

J Med Case Reports

View full text Add to dashboard Cite

Background Choosing the appropriate treatment approach for a multifocal comminuted open fracture of humerus with severe soft tissue defect is a challenging issue, which could be interesting for every orthopedic surgeon especially for those working in the trauma centers. Case presentation This study described an innovative approach using titanium elastic nailing to treat a multifocal comminuted open fracture of humerus with severe soft tissue defect. In this study, we report a 40-year-old Persian female patient in whom the treatment achieved complete fracture union and skin graft healing by elastic medullary nailing, vacuum dressing, and skin grafting. Conclusions Elastic medullary nailing is a viable option for reconstruction of simultaneous comminuted fracture and soft tissue defect.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful treatment of a multifocal comminuted open fracture of humerus with severe soft tissue defect: a case report

Barati

Afzal

2023

J Med Case Reports

View full text Add to dashboard Cite

show abstract

“…4,5 Safety of lateral-to-medial screws in the distal humerus has been described. 6,7 Risks of this approach include injury to the radial nerve and intraarticular breach of implants. Based on cadaveric studies, there are two areas of safety for placement of hardware percutaneously in order to avoid injury to the radial nerve.…”

Section: Discussionmentioning

confidence: 99%

“…The proximal safe zone exists from approximately 14.8 cm proximal to the lateral epicondyle to 5 cm distal to the acromion. 6 However, the distal zone is the area of focus in this study. The traditional safe zone in adults, as described by Gerwin et al, is based on the finding that the radial nerve crosses the intermuscular septum approximately 10 cm proximal to the lateral epicondyle and then becomes an anterior structure.…”

Section: Discussionmentioning

confidence: 99%

“…Plucknette et al described a lateral safe zone based on the transepicondylar width for external fixator pins, which is also very useful for placing percutaneous lag screws. 6 Despite the relative safety of this distal zone, we still recommend avoiding "stab incisions" to protect underlying structures, including the radial nerve. Small skin incisions with careful blunt dissection may be employed for guide pin and screw placement as well as clamp placement if the fracture may not be compressed otherwise in a closed manner.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Minimally Invasive Methods for Adolescent Intraarticular Distal Humerus Fractures with an Intact Column

Broussard¹,

Sanders²,

Accousti³

et al. 2023

Journal of the Pediatric Orthopaedic Society of North America

View full text Add to dashboard Cite

Intraarticular distal humerus fractures occur in adolescents and represent a unique morphology that is amenable to different surgical techniques than distal humerus fractures in adults or younger children, especially when one column remains intact. Despite articular involvement, a minimally invasive approach utilizing the intact periosteum and opposing intact column of bone can often achieve successful reduction and fixation. Here, we present an operative technique for these fractures along with four cases successfully treated with percutaneous lag screws.

show abstract

Anatomic consideration of the radial nerve in relation to humeral length for unilateral external fixation: a retrospective study using magnetic resonance imaging findings in korean

Min

Ryu

Sung

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background This study aimed to present a safe zone for distal pin insertion for external fixation using magnetic resonance imaging (MRI) images. Methods All patients who took at least one upper arm MRI from June 2003 to July 2021 were searched via a clinical data warehouse. For measuring the humerus length, proximal and distal landmarks were set as the highest protruding point of the humeral head and lowermost margin of ossified bone of the lateral condyle, respectively. For children or adolescents with incomplete ossification, the uppermost and lowermost ossified margin of the ossification centers were set as proximal and distal landmarks respectively. The anterior exit point (AEP) was defined as the location of the radial nerve exiting the lateral intermuscular septum to the anterior humerus and distance between the distal margin of the humerus and AEP was measured. The proportions between the AEP and full humeral length were calculated. Results A total of 132 patients were enrolled for final analysis. The mean humerus length was 29.4 cm (range 12.9–34.6 cm). The mean distance between the ossified lateral condyle and AEP was 6.6 cm (range 3.0–10.6 cm). The mean ratio of the anterior exit point and humeral length was 22.5% (range 15.1–30.8%). The minimum ratio was 15.1%. Conclusion A percutaneous distal pin insertion for humeral lengthening with an external fixator may be safely done within 15% length of the distal humerus. If pin insertion is required more proximal than distal 15% of the humeral shaft, an open procedure or preoperative radiographic assessment is advised to prevent iatrogenic radial nerve injury.

show abstract

Lateral External-fixation Adjacent to Radial Nerve

Abstract: Open Access Original Article

Cited by 3 publications

References 15 publications

Successful treatment of a multifocal comminuted open fracture of humerus with severe soft tissue defect: a case report

Successful treatment of a multifocal comminuted open fracture of humerus with severe soft tissue defect: a case report

Minimally Invasive Methods for Adolescent Intraarticular Distal Humerus Fractures with an Intact Column

Anatomic consideration of the radial nerve in relation to humeral length for unilateral external fixation: a retrospective study using magnetic resonance imaging findings in korean

Contact Info

Product

Resources

About