Nerve entrapment and reflex sympathetic dystrophy after fractures of the distal radius

• Published in: Scandinavian journal of plastic and reconstructive surgery and hand surgery Vol. 29; no. 1; p. 53
• Main Author: Hove, L M
• Format: Journal Article
• Language: English
• Published: England 1995
• Subjects: Autonomic Nervous System Diseases - etiology; Carpal Tunnel Syndrome - etiology; Carpal Tunnel Syndrome - surgery; Follow-Up Studies; Fracture Fixation; Fracture Healing; Hand - physiopathology; Humans; Incidence; Nerve Compression Syndromes - etiology; Nerve Compression Syndromes - surgery; Osteotomy; Pain - etiology; Prospective Studies; Radial Nerve - physiopathology; Radius Fractures - complications; Radius Fractures - therapy; Reflex Sympathetic Dystrophy - drug therapy; Reflex Sympathetic Dystrophy - etiology; Ulna - surgery; Ulnar Nerve - physiopathology
• ISSN: 0284-4311
• DOI: 10.3109/02844319509048424

In a series of 542 conservatively-treated fractures of the distal radius 30 patients (5,5%) developed compression neuropathy: of the median nerve (n = 23), of the ulnar nerve (n = 5), and of the radial nerve (n = 2). Three patients required decompression of the carpal tunnel, and one patient's ulnar symptoms were relieved after shortening osteotomy of the ulna. The remaining neuropathies resolved spontaneously over a period of three months. Five patients developed typical reflex sympathetic dystrophy with diffuse pain, loss of hand function, and significant autonomic dysfunction. None of them had specific signs of compression neuropathy anteceding the development of reflex dystrophy. All five had their joints mobilised under regional intravenous block combined with regional perfusion of soluble corticosteroid.