What is Holstein fracture?
Holstein–Lewis fracture: simple spiral fracture of the distal third of the shaft of humerus with distal bone fragment displaced and the proximal end deviated toward the radial side with an increased risk of acute radial nerve palsy.
What fractures damage the radial nerve?
A radial nerve injury associated with a humeral shaft fracture is an important injury pattern among trauma patients. It is the most common peripheral nerve injury associated with this fracture.
Which nerve is most likely damage in a fracture of middle and distal one third of humerus?
The radial nerve is most likely to be damaged in humerus fractures that have a lateral displacement of the distal fracture segment, as the nerve is tethered to the bone and cannot withstand the forces applied to it as a result of the displacement.
What nerve and artery are lesioned with a spiral fracture of the humerus?
Spiral fractures of the distal humeral shaft at the level where the radial nerve exits the posterior compartment through the intramuscular septum are associated with radial nerve palsies.
What nerve is affected in supracondylar fracture?
The anterior interosseous nerve is most commonly affected by the initial injury, however ulnar nerve palsy is the most common post-operative complication.
What is radial nerve injury?
A radial nerve injury usually causes symptoms in the back of your hand, near your thumb, and in your index and middle fingers. Symptoms may include a sharp or burning pain, as well as unusual sensations in your thumb and fingers. It’s common to experience numbness, tingling, and trouble straightening your arm.
What muscles are innervated by the radial nerve?
The radial nerve and its branches provide innervation the following muscles (See Structure and Function for specific nerve branch innervations and muscle actions)[7]:
- Abductor pollicis longus.
- Anconeus.
- Brachioradialis.
- Extensor carpi radialis brevis.
- Extensor carpi radialis longus.
- Extensor carpi ulnaris.
What part of the humerus is the most commonly fractured?
The most frequently fractured site of the humerus especially in elderly is the surgical neck which is an area of constriction distal to the tuberosities. The deforming forces relevant to PHFs include: pectoralis major: displaces humeral shaft anterior/medial.
Does radial nerve palsy go away?
Many patients with radial nerve palsy will see complete recovery or symptom relief after treatment. In some cases, complications may occur, including: Partial or complete loss of feeling in the hand: If the radial nerve doesn’t heal completely, numbness may be permanent.
What are the aspects of the Holstein-Lewis humeral shaft fracture?
The Holstein-Lewis humeral shaft fracture: aspects of radial nerve injury, primary treatment, and outcome The Holstein-Lewis humeral shaft fracture was associated with a significantly increased risk of acute radial nerve palsy.
Where does the radial nerve originate in a Lewis fracture?
Holstein – Lewis fracture is a spiral fracture involving the distal third of the humerus, which causes entrapment of the radial nerve.The radial nerve originates from the posterior cord of the brachial plexus.
How are fractures of the humerus related to radial nerve palsy?
They hypothesized that the high association with radial nerve palsy was that the fracture occurred at the site of radial nerve runs through the lateral intermuscular septum in direct contact with the bone and with limited mobility. Holstein A, Lewis GM. Fractures of the humerus with radial-nerve paralysis.
When to start EMG for Holstein Lewis fracture?
• The humerus is flat posteriorly, easy to apply the plate. • Nerve exploration may be difficult. • The fracture is treated usually without surgery according to the principles of fracture treatment. • Observe the nerve for recovery. Radial nerve palsy is not contraindicated of functional bracing. Start obtaining EMG at 3-4 weeks.
