Nerve complications in closed fractures of the lower end of the radius

Abstract

Nineteen cases of nerve complications following closed fractures of the lower end of the radius (17 lesions of the median nerve, 4 of which were associated with lesions of the ulnar nerve, and 2 isolated lesions of the ulnar) were observed. A therapeutic approach may be suggested for lesions of the median nerve and/or the ulnar nerve: immediate lesions: immediate reduction, gently if possible and avoiding the position of volar flexion and ulnar deviation. Early secondary lesions associated with immobilization in flexion and ulnar deviation: modify the position and complementary pinning when necessary. Deterioration----neurolysis: no improvement----neurolysis at the 6th month. Early secondary lesions following immobilization in a neutral position: same approach as previous case. Late cases: in absence of malunion or in presence of a minimal malunion: division of the carpal tunnel and/or Guyon's canal. Exceptionally associated fascicular neurolysis. In presence of malunion: corrective osteotomy, completed in serious cases of compression syndrome by a division of the canals.