PURPOSE: Stabilization of humeral shaft and elbow fractures can be achieved with an external-fixator. Reports about nerve injuries associated with this procedure are rare in literature. Purpose of this anatomical study was to examine the relation of the radial nerve to distal humeral half pins. METHODS: Percutaneous insertion of external-fixator half pins was performed in 20 upper limbs of 20 cadavers, according to established technique, laterally in the distal humerus. RESULTS: Dissection of the upper limbs showed radial nerve injury in four of the 40 placed half pins. The proximal half pin impaled the nerve in one case and the distal half pin in three cases. Moreover the nerve was directly in contact with the pins in nine cases (five proximally, four distally). CONCLUSIONS: Insertion of external-fixator half pins in the distal humerus can easily injure the radial nerve. Thus we advocate a larger skin incision, blunt dissection to the lateral cortex of the humerus and retraction of soft tissue during half pin insertion.
PURPOSE: Stabilization of humeral shaft and elbow fractures can be achieved with an external-fixator. Reports about nerve injuries associated with this procedure are rare in literature. Purpose of this anatomical study was to examine the relation of the radial nerve to distal humeral half pins. METHODS: Percutaneous insertion of external-fixator half pins was performed in 20 upper limbs of 20 cadavers, according to established technique, laterally in the distal humerus. RESULTS: Dissection of the upper limbs showed radial nerve injury in four of the 40 placed half pins. The proximal half pin impaled the nerve in one case and the distal half pin in three cases. Moreover the nerve was directly in contact with the pins in nine cases (five proximally, four distally). CONCLUSIONS: Insertion of external-fixator half pins in the distal humerus can easily injure the radial nerve. Thus we advocate a larger skin incision, blunt dissection to the lateral cortex of the humerus and retraction of soft tissue during half pin insertion.
Authors: Andrea Laufer; Jan Duedal Rölfing; Georg Gosheger; Gregor Toporowski; Adrien Frommer; Robert Roedl; Bjoern Vogt Journal: Clin Orthop Relat Res Date: 2022-04-25 Impact factor: 4.755
Authors: Juan P Simone; Philipp N Streubel; Joaquín Sánchez-Sotelo; Scott P Steinmann; Julie E Adams Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2019-02-20