Peripheral Nerve Injuries · NEET PG Preparation Orthopaedics
A 25-year-old male sustains a mid-shaft fracture of the humerus following a road traffic accident. On examination, he is unable to actively extend hi…
Practice question from Peripheral Nerve Injuries (NEET PG Preparation Orthopaedics), with the correct answer and a step-by-step solution.
easy · MCQ · Q-D0E1DD
A 25-year-old male sustains a mid-shaft fracture of the humerus following a road traffic accident. On examination, he is unable to actively extend his wrist and fingers and has loss of sensation over the first dorsal interosseous space. Which of the following is the most appropriate initial management for this closed fracture with a primary radial nerve palsy?
- A.Immediate open reduction and internal fixation with radial nerve exploration
- B.Closed reduction, slab immobilization, and observation with serial clinical examinationsCorrect answer
- C.Urgent nerve conduction studies followed by surgical exploration if absent within 48 hours
- D.Immediate tendon transfer of flexor carpi ulnaris to extensor digitorum communis
Solution
Primary radial nerve palsy associated with closed humeral shaft fractures is most commonly a neurapraxia (conduction block) due to contusion or stretching. The vast majority recover spontaneously without surgical intervention. Therefore, initial management consists of closed reduction and observation, as immediate exploration is generally reserved for open fractures, penetrating injuries, or palsies that develop secondary to manipulation.
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