Journal of Musculoskeletal Trauma

Delayed Sciatic Nerve Palsy due to Hematoma Related with Anticoagulants Prophylaxis in the Femur Intramedullary Nailing: A Case Report: Young Mo Kim, Yong Bum Joo, Seok Hwan Song; J Korean Fract Soc 2017;30(4):198-202. Published online October 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.4.198

Femur intramedullary nailing can be one of the most predictable procedures in orthopedic traumatology. The advantage of this method is that the fracture site does not have to be widely exposed for reduction, which can minimize soft tissue damage. For this reason, the incidence of complications related to hematoma has been rare. We experienced only one case of sciatic nerve palsy due to hematoma after intramedullary nailing; the patient was receiving an anticoagulant therapy. Therefore, we report this case with literature review.

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Ipsilateral Foot Drop After Leg Traction on Fracture Table for Mid-Shaft Femur Fracture Nailing: A Rare Case Report
Jehad A Alzahrani, Ahmed A Alabdali, Mohammed O Albariqi
Cureus.2023;[Epub] CrossRef

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Contributing Factors of Radial Nerve Palsy Associated with Humeral Shaft Fracture: Tae Soo Park, Joon Hwan Lee, Tai Seung Kim, Kwang Hyun Lee, Ki Chul Park; J Korean Fract Soc 2008;21(4):292-296. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.292

Abstract PDF

PURPOSE
To analyze related factors of radial nerve palsy in patients with humeral shaft fractures.
MATERIALS AND METHODS
We reviewed 107 paients with humeral shaft fracture between January 2000 and June 2007. Thirteen patients had radial nerve palsy after trauma and 9 patients after the operation. We analyzed contributing factors of radial nerve palsy associated with humeral shaft fracture including the cause of trauma, location and pattern of fracture, surgical approach and tourniquet application in cases of plate fixation, the exploration for the nerve and the time for operation.
RESULTS
The difference in the incidences of radial nerve palsy after trauma and operation was not significant according to the location and pattern of fracture. The tendency of higher rate of radial nerve palsy after trauma in oblique or comminuted fractures, and after operation in spiral fractures was observed. The operation using intramedullary nailing and radial nerve exploration significantly reduced the incidence of radial nerve palsy after operation (p=0.01 and p=0.02). Posterior approach in open reduction and plate fixation showed a tendency of lower incidence of radial nerve palsy after operation (p=0.78). In logistic regression analysis, radial nerve exploration was the only significant factor that reduced the possibility of radial nerve palsy after operation (17.27: odds ratio, p=0.02).
CONCLUSION
In humeral shaft fractures, we should take into consideration whether intramedullary nailing is possible or not. In cases of anterior or anterolateral approach of open reduction and plate fixation, radial nerve should be carefully inspected. In most cases, we recommend radial nerve exploration in order to minimize the possibility of radial nerve palsy after operation.

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Treatment of Radial Nerve Palsy Associated with Humeral Shaft Fracture
Soo-Hong Han, Jin-Woo Cho, Han-Seung Ryu
Archives of Hand and Microsurgery.2020; 25(1): 60. CrossRef
Associated Factors of Radial Nerve Palsy Combined with Humerus Shaft Fracture
Si-Wuk Lee, Chul-Hyun Cho, Ki-Choer Bae
Journal of the Korean Fracture Society.2014; 27(3): 185. CrossRef
Polarus Intramedullary Nail for Proximal Humeral and Humeral Shaft Fractures in Elderly Patients with Osteoporosis
Youn-Soo Hwang, Kwang-Yeol Kim, Hyung-Chun Kim, Su-Han Ahn, Dong-Eun Lee
Journal of the Korean Fracture Society.2013; 26(1): 14. CrossRef

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Combined Femoral and Sciatic Nerve Palsy Associated with Acetabular Fracture and Dislocation: A Case Report: Ki Chul Park, Kang Wook Kim, Young Ho Kim; J Korean Fract Soc 2005;18(3):341-344. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.341

Abstract PDF

Sciatic nerve palsy is the most common nerve injury associated with acetabular fracture and dislocation, but femoral nerve injury is known to be very rare because of relative protected position of nerve between the iliacus and psoas muscle, and as far as we know only one report was noted in English about combined femoral and sciatic nerve injury associated with acetabular fracture and dislocation, so we hereby report a case of combined femoral and sciatic nerve palsy associated with acetabular fracture and dislocation.

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Effects of Unilateral Sciatic Nerve Injury on Unaffected Hindlimb Muscles of Rats
Jin Il Kim, Myoung-Ae Choe
Journal of Korean Academy of Nursing.2009; 39(3): 393. CrossRef

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Ulnar nerve palsy After Percutaneous Pinning in Childrens Supracondylar fracture: Tai Seung Kim, Jay Rim Choi, Kuhn Sung Whang; J Korean Soc Fract 1999;12(3):674-678. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.674

Abstract PDF: Many authors have described percutaneous pinning techniques as the treatment of choice for most supracondylar fractures. But little information is available concerning ulnar nerve injury resulting from pinning techniques. When the surgeon is faced with a postoperative ulnar nerve palsy, it can be the result of unrecognized preoperative palsy, manipulation during surgery, or damage to the nerve by one of the medial pin placements. The options for management include exploration, medial pin removal, or observation. We reviewed our hospital records on the 132 supracondylar elbow fractures that we treated in children from 1991 to 1998 There were 16 palsies found with normal preoperative and abnormal postoperative ulnar nerve function. Normal nerve function returned without exploration and early medial pin removal in all cases. We recommand that observation is the appropriate way to manage these postoperative ulnar nerve palsies in most cases.

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Tardy Ulnar Nerve Palsy Caused by Post-Traumatic Elbow deformities: Seung koo Rhee, seok Whan Song, Hwa Sung Lee, Ho Tae Kim; J Korean Soc Fract 1998;11(2):420-426. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.420

Abstract PDF: Thirty-five patients with tardy ulnar nerve palsy caused by cubitus valgus (33 cases0 and varus (2 cases) deformities were retrospectively studied. All patients had a history of old fracture on the distal humerus during childhood. The mean interval between the previous fractures and the onset of ulnar neuropathy was 19 years. The severity of nerve palsy was classified as McGowan's grade I in 24 patients, grade II in 8 patients, and grade III in 3 patients. The mean carrying angle was average 29 degrees in 33 cases with cubitus valgus and it was decreased to average 11 degrees postoperatively, but the angle was average -23 degrees preoperatively in 2 cases with cubitus varus and it was corrected to average 9 degrees postoperatively. the cause of palsy was analysed by mechanical stetching in 11 cases, compression by a fibrous band between the two heads of flexor carpi ulnaris in 8 cases, and diffuse fibrous adhesion around the ulnar tunnel in 5 cases. All patients was treated with supracondylar closing wedge osteotomy accompanied with anterior ulnar nerve transposition in 13 patients, corrective osteotomy only in 12 patients, and anterior ulnar nerve transposition only in 10 patients. Their end results were analysed as good in 24 cases, fair in 8 cases, and poor in 3 cases within average 6 months after the operations (4 to 13 months). The poor results was obtained in 3 cases out of 9 cases with corrective osteotomy group (33.3%). Conclusively, a tardy ulnar nerve palsy caused by post-traumatic elbow deformities should be corredcted with anterior ulnar nerve transposition with or without corrective closing wedge osteotomy but not by corrective osteotomy only, because of compressive neuropathy by diffuse fibrous adhesion or bands of two heads of FCU around the ulnar tunnel in elbow.

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Fracture of the Distal Radius with Ulnar Nerve Palsy: Chil Soo Kwon, Jong Kuk Ahn, Jin Hyok Kim, Yerl Bo Sung, Jin Ho Cho; J Korean Soc Fract 1997;10(1):171-174. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.171

Abstract PDF

There are several complications of distal radiug fracture such as median nerve injury, malunion nonunion, rupture of EPL, and ischemic contracture. Lesion of ulnar nerve as a complication of fracture of the distal radius are very rare. The authors report 1 case of the distal radius fracture with ulnar nerve palsy. The electromyography & nerve-conduction studies showed incomplete axonotmesis of ulnar nerve on 1 month following injury. A second electromyography & nerve-conduction study two months after injury showed complete recovery of nerve function.

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Ulnar Nerve Palsy Following Closed Fracture of the Distal Radius: A Report of 2 Cases
Chul-Hyun Cho, Chul-Hyung Kang, Jae-Hoon Jung
Clinics in Orthopedic Surgery.2010; 2(1): 55. CrossRef

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Treatment of Fractures of Lateral Condyle of Humerus with Compliations: Moon Sang Chung, Sung Churl Lee; J Korean Soc Fract 1995;8(3):659-666. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.659

Abstract PDF

Fractures of the lateral condyle of the humerus are notorious for complications, most commonly nonunion with subsequent proximal migration of the ununited fragment, an increase in the carrying angle, and the tardy ulnar nerve palsy. In the past, the reconstructive surgery for complicated old fractures of the lateral condyle of the humerus had been hardly considered, but recently, attempts have been made to reconstruct the anatomy and function of the elbow joint. The authors have reviewed 21 cases of old fractures of the lateral condyle of the humerus, which had been treated at Seoul National University Hospital from April,1982 until March, 1990. For established nonunions of the lateral condyle fragment, better results were obtained from the procedure that includes osteosynthesis of the lateral condyle, attempting to restore the normal anatomy of the elbow joint. For tardy ulnar nerve palsies, better results were obtained from the procedure that includes medial epicondylectorny. Fractures of the lateral humeral condyle have many late problems in spite of treatment at the time of injury so early aggressive treatment is necessary. Even in cases with late problems, aggressive treatment should be done, too, as soon as possible.

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In SituLate Metaphyseal Osteosynthesis for the Fractures of the Lateral Humeral Condyle in Children
Kun Bo Park, Seung Whan Lee, Hyun Woo Kim, Hui Wan Park, Ki Seok Lee
Journal of the Korean Fracture Society.2008; 21(2): 151. CrossRef

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