image based Q.16- a fractured arm

Q. What is the possible nerve injury with below fracture ?

1. Median nerve

2. Radial nerve

3. Anterior interosseous nerve

4. Musculocutaneous nerve

Answer – 2

The typical fracture of distal third of humerus with lateral spike may injure radial nerve as the nerve passes anterior from posterior side through intermuscular septa at lateral aspect of distal humerus.

This typical fracture pattern with propensity of associated radial nerve injury is called  Holstein Lewis fracture pattern.

Radial nerve injury with fracture shaft humerus is mostly seen in middle third fractures. 

The reported incidence of humerus fracture with associated radial nerve injury is 18%.