JAAOS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

J Am Acad Orthop Surg, Vol 14, No 1, January 2006, 32-37.
© 2006 the American Academy of Orthopaedic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Mohler, L. R.
Right arrow Articles by Hanel, D. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mohler, L. R.
Right arrow Articles by Hanel, D. P.

Closed Fractures Complicated by Peripheral Nerve Injury

L. Randall Mohler, MD and Douglas P. Hanel, MD

Dr. Mohler is Fellow, Section of Hand and Microvascular Surgery, Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA. Dr. Hanel is Professor, Section of Hand and Microvascular Surgery, Department of Orthopaedics and Sports Medicine, University of Washington, Seattle.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Mohler and Dr. Hanel.

Reprint requests: Dr. Hanel, Department of Orthopaedics and Sports Medicine, University of Washington, Box 359798, 325 Ninth Avenue, Seattle, WA 98104-2499.

Closed fractures may be complicated by associated peripheral nerve injury. However, because clinical information is limited, determining the best course of treatment is difficult. Most patients with closed fractures have a local nerve injury without nerve division; their prognosis for recovery is favorable. In the acute setting, immediate surgery is usually unwarranted because of the difficulty in accurately defining the severity and extent of nerve injury. When débridement of an open fracture or repair is not required, peripheral nerve injuries are best observed and the extremity treated with splinting and exercise to prevent loss of joint motion. Patients who fail to demonstrate signs of recovery at 6 months, either clinically or with electrodiagnostic testing, should undergo exploration to maximize the likelihood for return of function. When, during exploration, the nerve is in continuity, intraoperative measurement of nerve action potentials should be done. Measuring nerve action potentials will determine whether nerve grafting, local neurolysis, or excision of the injured segment, accompanied by primary repair, is the most appropriate treatment.




This article has been cited by other articles:


Home page
 JBJSHome page
J. O. Anglen, M. T. Archdeacon, L. K. Cannada, and D. Herscovici Jr.
Avoiding Complications in the Treatment of Humeral Fractures
J. Bone Joint Surg. Am., July 1, 2008; 90(7): 1580 - 1589.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Academy of Orthopaedic Surgeons.