Radial nerve injury following elbow external fixator: report of three cases and literature review

Trigo, Luis; Sarasquete, J.; Noguera, L.; Proubasta, I.; Lamas, C.

doi:10.1007/s00402-017-2711-1

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…External fixation involving the humerus should be made cautiously, especially regarding inserting percutaneous pins over the distal aspect. Several studies, mostly case reports and series, highlight the occurrence of radial nerve palsy after percutaneous application of external fixator 18 - 23 . For open reduction and internal fixation cases using plate and screws (either the standard open or the minimally invasive plate osteosynthesis [MIPO] technique), nerve injury may occur when the plate is placed over or under the nerve and due to the surgical approach used (lateral or posterior).…”

Section: Discussionmentioning

confidence: 99%

Measurement of the Radial Nerve Danger Zone in Filipino Adults: A Cadaveric Study

DA¹,

Pacheco²,

Abrilla³

2021

Malays Orthop J

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Introduction: The radial nerve danger zone (RNDZ) is an important anatomic consideration to anticipate or prevent injury in trauma assessment or surgical fixation. No published estimate currently exists for Filipinos. In this study, we sought to provide a local estimate and explore potential predictors of this anatomic region in Filipino adult cadavers. Materials and methods: Posterior dissection to expose and measure the radial nerve, from the lateral epicondyle to the lateral intermuscular septum, was performed in 60 upper limbs from 30 formalin-preserved cadavers in the laboratory of the Department of Anatomy, College of Medicine, University of the Philippines Manila. Univariate and multivariate linear regression modelling was performed with RNDZ as the dependent variable and age, sex, height and humeral length as potential independent variables individually and in combinations. Results: The mean radial nerve length from the lateral epicondyle to the lateral intermuscular septum was estimated at 10.6 cm (95% confidence interval: 10.3 cm, 10.9cm). Height and humeral length were statistically significant univariate predictors in female cadavers, while only height was significant in male cadavers. In addition, all multivariate regression models were statistically significant and accounted for more than 57% of the variability in female RNDZ estimates. In comparison, only models that included height and age were statistically significant predictors of RNDZ and accounted for at most 22% of the variability of the estimate in males. Conclusion: The estimated length of the radial nerve danger zone generated in this study should be strongly considered over other published estimates in surgical fixation procedures performed in adult Filipinos.

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Section: Discussionmentioning

confidence: 99%

Measurement of the Radial Nerve Danger Zone in Filipino Adults: A Cadaveric Study

DA¹,

Pacheco²,

Abrilla³

2021

Malays Orthop J

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“…Secondary traumatic and/or iatrogentic radial nerve damage after surgery (open reduction and internal plate fixation, intramedullary nailing, total elbow arthroplasties) may occur in up to 32% of patients who undergo surgical treatments at the humerus [ 3 , 4 ]. Iatrogenic RNP was observed in single cases after venipuncture, automatic blood pressure measurement, intramuscular injections and external fixation of the elbow as well [ 5 - 8 ]. Other causes for “trauma-related” RNP without an external injury or surgical intervention can be acute muscle compressions ( i.e.…”

Section: Discussionmentioning

confidence: 99%

Irreparable Radial Nerve Palsy Due to Delayed Diagnostic Management of a Giant Lipoma at the Proximal Forearm Resulting in a Triple Tendon Transfer Procedure: Case report and Brief Review of Literature

Schmidt¹

2017

TOORTHJ

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Background:Non-traumatic radial nerve palsy (RNP) caused by local tumors is a rare and uncommon entity.Methods:A 62-year-old female presented with a left non-traumatic RNP, initially starting with weakness only. It was caused by a benign giant lipoma at the proximal forearm that was misdiagnosed over a period of 2 years. The slowly growth of the tumor led to an irreparable overstretching-related partial nerve disruption. For functional recovery of the patient, a triple tendon transfer procedure had to be performed.Results:Four months after surgery, the patient was completely able to perform her activities of daily living again. At the 10-months follow-up, strength of wrist extension, thumb's extension and abduction, and long fingers II-V extension had all improved to grade 4 in Medical Research Council scale (0-5). In order to restore motion, the patient reported that she would undergo the same triple tendon transfer procedure a second time where necessary. Due to the initially misdiagnosed tumor, there was an overall delayed duration of time for functional recovery of the patient.Conclusion:The triple tendon transfer procedure offers a useful and reliable method to restore functionality for patients sustaining irreparable RNP. However, it must be noted critically with our patient that this procedure probably would have been avoided. Initially, there was weakness only by entrapment of the radial nerve. RNP caused by local tumors are uncommon but known from the literature, and so it should be considered generally in differential diagnosis of non-traumatic RNP.

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External Fixation of the Elbow

DiBenedetto

Baumfeld

Tolo

2022

Tips and Techniques in Elbow Surgery

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Radial nerve injury following elbow external fixator: report of three cases and literature review

Abstract: Radial nerve palsy after placement of an external elbow fixator was resolved in only 1 of our 3 cases and in 6 of the 11 cases in the literature to date. Although the event is rare, these alarming results highlight the need for recommendations to avoid this complication.

Cited by 9 publications

References 17 publications

Measurement of the Radial Nerve Danger Zone in Filipino Adults: A Cadaveric Study

Measurement of the Radial Nerve Danger Zone in Filipino Adults: A Cadaveric Study

Irreparable Radial Nerve Palsy Due to Delayed Diagnostic Management of a Giant Lipoma at the Proximal Forearm Resulting in a Triple Tendon Transfer Procedure: Case report and Brief Review of Literature

External Fixation of the Elbow

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