17- EVALUATION OF PERIPHERAL NERVE INJURIES AROUND ELBOW IN ASSOCIATION WITH FRACTURES
Basrah Journal of Surgery,
2011, Volume 17, Issue 1, Pages 0-0
AbstractAlaa A Dawood# & Ali Hamzaa*
#MB,ChB, FICMS, Orthopaedic Surgeon, Lecturer, Dept. Of Surgery, College of Medicine, University of
Basrah. *MB,ChB, Orthopaedic Surgeon, Basrah General Hospital, Basrah, IRAQ.
In this prospective study, 147 cases of trauma around elbow were examined and evaluated. All
were unilateral. Only 22 were associated with peripheral nerve injuries (14.9%). Males were 19
(86%) and females were 3 (14%). Their ages were between 5 and 54 years (mean 24 years).
The radial nerve was found to be most vulnerable to injury (40.9%) followed by ulnar nerve
(31.8%) and lastly the median nerve (9.1%).
The injurious agents in 2 patients were bullet and missile while in 20 were civilian causes.
In thirteen cases (59.1%) there were primary nerve palsy and in 9 (40.9%) there were
secondary nerve palsies.
The degree of nerve injury in 13 patients were neuropraxia (59.1%) with complete recovery, in
6 were neurotmesis (27.3%) and in 3 were axonotmesis (13.6%).
The full recovery of the nerve was in 13 patients (59.1%), 12 of them by spontaneous recovery
(54.5%) and one of them by surgical exploration and neurolysis (4.5%).Timing of nerve recovery
were variable, range from 1.5 to 8 months. There was no recovery in 9 patients (40.9%).
We concluded that when closed fractures are complicated by primary nerve deficits, waiting for
spontaneous re-innervation seems reasonable up to eight months and early surgical exploration
is better to be avoided, conversely if closed fracture complicated by secondary nerve palsy early
exploration of nerve is favored except in Tourniquet palsies.
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