Kiloh-Nevin syndrome associated with humeral shaft fracture

Abstract

Fracture humerus may be associated with nerve injuries. However, among them median nerve is uncommonly involved and clinical affection of the anterior branch of median nerve is rare which can be easily missed and could be under-reported. A 42-year-old man presented with closed fracture of shaft of humerus right sided following fall. He had isolated weakness of flexor pollicis longus and flexor digitorum profundus of index finger without any other sensorimotor dysfunction. The findings were consistent with isolated palsy of anterior interosseous nerve (AIN). The patient was operated with fixation of humerus without exploring the AIN. At 6-month follow-up, the patient had complete recovery of both the muscles. This case highlights the classical clinical presentation of a rare injury associated with humerus fracture. Awareness and knowledge of this entity is of paramount importance for the practitioners.

Keywords: disability; elbow fracture; neurological injury; trauma.

Figure 1

X-rays of the patient preoperative (A) and postoperative (B) demonstrating fracture shaft of humerus and fixation on the right side.

Figure 2

Clinical picture showing the inability to demonstrate the ‘O’ by using index and thumb in the affected right hand (inset arrow).