1/102. Transient peroneal nerve palsies from injuries placed in traction splints.Two patients thought to have distal femur fractures presented to the emergency department (ED) of a level 1 trauma center with traction splints applied to their lower extremities. Both patients had varying degrees of peroneal nerve palsies. Neither patient sustained a fracture, but both had a lateral collateral ligament injury and one an associated anterior cruciate ligament tear. One patient had a sensory and motor block, while the other had loss of sensation on the dorsum of his foot. After removal of the traction splint both regained peroneal nerve function within 6 hours. Although assessment of ligamentous knee injuries are not a priority in the trauma setting, clinicians should be aware of this possible complication in a patient with a lateral soft tissue injury to the knee who is placed in a traction splint that is not indicated for immobilization of this type of injury.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/102. Anterior interosseous nerve compression after supracondylar fracture of the humerus: a metaanalysis.OBJECT: The authors conducted a metaanalysis of reports of anterior interosseous nerve syndrome, a rare nerve compression neuropathy that affects only the motor branch of the median nerve. This syndrome is characterized by paralysis of the flexor pollicis longus, the flexor digitorum profundus to the index finger, and the pronator quadratus, with weakness on flexion of the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger without sensory loss. methods: The authors reviewed reports of 34 cases of anterior interosseous nerve syndrome combined with supracondylar fractures of the humerus in children. They have added a new case identified in a 7-year-old boy in whom a diagnosis was made from the clinical findings and whose treatment and outcome are analyzed. The ages of patients reported in the literature ranged from 4 to 10 years. Ten patients (29%) were treated with closed reduction and application of a cast, whereas 25 patients (71%) were treated with open reduction and fixation of the fracture. CONCLUSIONS: All patients regained full flexion and strength after 4 to 17 weeks. The fractures that were surgically treated showed no entrapment of the anterior interosseous nerve.- - - - - - - - - - ranking = 3.5keywords = fracture (Clic here for more details about this article) |
3/102. Laminar and arch fractures with dural tear and nerve root entrapment in patients operated upon for thoracic and lumbar spine injuries.OBJECTIVE: To determine the neurological outcome in patients with laminar fractures associated with dural tears and nerve root entrapment, operated upon for thoracic and lumbar spine injuries. PATIENT population: Out of 103 patients operated upon consecutively for thoracic and lumbar spine injuries during the period 1990 to 1994 inclusive, 24 (23.3%) patients had laminar fractures out of whom 3 (2.9%) had an associated dural tear and an other 17 (16.5% or 70.8% of the total patients with laminar fractures) had an associated dural tear and nerve root entrapment. RESULTS: Twelve (70.5%) patients had injury at the thoraculumbar junction, 13 (76.5%) had Magerl's type A3 or above, 10 (58.8%) had a kyphotic angle deformity greater than 5 degrees. Seven (41.1%) had their spinal canal's sagittal diameter reduced by at least 50% and two had dislocations. Nine (52.9%) had initial neurological deficits. Four (50%) out of 8 patients with no initial neurological deficits (Frankel E) worsened to Frankel D. However, one patient among the 3 with initial Frankel A improved to Frankel C while both patients with initial Frankel C usefully improved to final Frankel grades D and E respectively. Two of the four patients with initial Frankel D improved to Frankel E, the other 2 remaining unchanged. All in all five patients neurological status improved, 4 worsened and 8 remained unchanged after neurosurgical treatment. CONCLUSIONS: Vertical laminar fractures with dural tears and nerve root entrapment represent a special group of thoracic and lumbar spine injuries that carry a poor prognosis. However, special operative precautions lead to significant improvement in some of them although a majority remain unchanged or even worsened.- - - - - - - - - - ranking = 4keywords = fracture (Clic here for more details about this article) |
4/102. Sonographic detection of radial nerve entrapment within a humerus fracture.radial neuropathy is frequently associated with fracture of the middle third of the humerus owing to the course of the nerve adjacent to the humeral shaft. The prevalence varies from 2 to 18% of humeral fractures. The therapeutic management is still controversial. Some authors recommend initial surgical exploration, whereas others prefer observation and intervention only if the injured nerve failed to recover after a period of more than 4 months. According to the literature, verification of an entrapped radial nerve in a fracture gap requires surgical exploration, but diagnostic tools to verify the existence of a pathologic condition are limited. We describe the sonographic findings of an entrapped radial nerve and review the literature regarding diagnosis and treatment of entrapped radial nerve in cases of humeral fracture.- - - - - - - - - - ranking = 4keywords = fracture (Clic here for more details about this article) |
5/102. radial nerve entrapment by the lateral intermuscular septum after trauma.radial nerve palsy is associated with humeral shaft fractures, usually occurring at the time of injury but sometimes occurring later. We report on a case in which a progressive radial nerve palsy occurred three months after a fracture; on exploration, the nerve was found to be trapped by the lateral intermuscular septum. It is important to recognize progressive radial nerve palsies or late presentations, because they often represent chronic compression and a delay in exploration may be detrimental to the return of nerve function.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
6/102. Entrapment of the median nerve in a greenstick forearm fracture. A case report and review of the literature.We report a case of low median nerve palsy occurring as a complication of a closed both-bone forearm fracture in a child. Following delayed diagnosis, surgical exploration was performed and it was observed that the median nerve was entrapped in the callus of the radius fracture.- - - - - - - - - - ranking = 3keywords = fracture (Clic here for more details about this article) |
7/102. median nerve compression associated with displaced Salter-Harris type II distal radial epiphyseal fracture.Three children with grossly displaced Salter-Harris Type II fractures of the distal radial epiphysis underwent immediate manipulation under anaesthetic (MUA) because of rapidly developing median nerve compression. In each case nerve function was quickly restored with no late neurological sequelae. We believe that in children who sustain this injury with signs of median nerve compression, immediate MUA without carpal tunnel release is acceptable initial management. Late exploration of the median nerve can be considered should a neurological deficit persist.- - - - - - - - - - ranking = 2.5keywords = fracture (Clic here for more details about this article) |
8/102. Entrapment of the sensory branch of the radial nerve (Wartenberg's syndrome): an unusual cause.Isolated neuropathy of the cutaneous branch of the radial nerve is a rarely recognized pathology. It was described in 1932 by Wartenberg, who suggested the name cheiralgia paraesthetica. The syndrome is described as known the entrapment of the superficial branch of the radial nerve. Many different etiologic factors for chronic nerve entrapment have been described, however our case has an unusual cause. A 52 year old man had pain and paresthesia in the area over the lateral aspect of the wrist, thumb and first web six months after colles' fracture. The patient underwent bony spike resection after five months with ineffective conservative treatment. He has satisfied after this operation. The case was presented because of disappearing his preoperative complaints after the operation with respect to Wartenberg's syndrome constituted a rare cause of bone spike which has not been mentioned in the literature.- - - - - - - - - - ranking = 0.5keywords = fracture (Clic here for more details about this article) |
9/102. Intraarticular entrapment of the obturator nerve in acetabular fracture.SUMMARY: The authors report a case of acetabular fracture of both columns that was associated with a rare nerve injury, entrapment of the obturator nerve in the hip joint.- - - - - - - - - - ranking = 2.5keywords = fracture (Clic here for more details about this article) |
10/102. Entrapment and transection of the median nerve associated with minimally displaced fractures of the forearm: case report and review of the literature.Complete transection of the median nerve associated with minimally displaced fractures of forearm bones is described in a 20-year-old woman. An end-to-end epineural repair was performed. There was good sensory and motor recovery of the median nerve in the hand.- - - - - - - - - - ranking = 2.5keywords = fracture (Clic here for more details about this article) |
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