A 5-year-old boy presents to the Accident Clinic with a fracture in the shaft of humerus. Then how will you exclude the involvement of radial nerve?
Correct Answer: Inability in extension of wrist and loss of sensation in area over anatomical snuff box
Description: (B) Inability in extension of wrist and loss of sensation in area over anatomical snuff box# Most common form is radial nerve injuries associated with humeral fractures.> Most common injury resulting from dislocations or fracture-dislocation of the elbow seems to be ulnar nerve neurapraxia, which spontaneously resolves after a closed reduction.> Radial nerve palsy after fracture of the humerus is the most common nerve lesion in long bone fractures.> Average incidence of radial nerve lesions is approximately 11%. Most reported series of radial nerve lesions are associated with fractures of the middle third of the humerus.> Formed by: Axons from C5 to T1 roots> Axons pass through Spiral groove of humerus Fibrous arch attachment of triceps to humerus Lateral intermuscular septum below deltoid insertion Arcade ofFrohse: Above supinator & Below elbow> Branches: Above elbow1. Above spiral groove (Humerus) Triceps: 3 to 5 branches Anconeus2. Below spiral groove Brachioradialis: Distal to lateral intermuscular septum Extensor carpi radialis longus & brevis Posterior cutaneous nerves of arm & forearm - Supply lateral & dorsolateral arm & forearm - At or below elbow> Above arcade of Frohse (Supinator) Superficial radial nerve: Sensory dorsolateral hand & 1 st 3 digits Posterior interosseus nerve - Extensor carpi radialis brevis & Supinator - Passes through arcade of Frohse Posterior interosseus nerve - Terminal motor branch Passes through the supinator muscle> Innervates Finger & thumb extensors Extensor carpi ulnaris Abductor pollicis longus Articular branches to wrist joint> Wrist drop is the classical sign of radial nerve injury
Category:
Orthopaedics
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