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Arm Spiral Fracture, Damaged Radial Nerve. Had Metal Plate Inserted. Taking Vitamin 2. Sounds Serious?
Hi Following a fall forward I broke my upper arm - spiral fracture (3 months) ago and have also had probs with wrist palsey from a damaged radial nerve. I had a metal plate inserted in my arm. Upper arm is now quite strong and scar healed nicely. A few weeks ago they also found a fracture in my wrist. Fortunately as I have been wearing a wrist support for my wrist and fingers, the wrist fracture has mended without probs. I see an OT fortnightly now, and started seeing an acupuncturist. The Ortho Surgeon is talking about a nerve replacement. There has been slight improvement in the wrist but I think has to do with the fracture improving. Some strength has returned to the fingers/wrist but unable to raise the wrist or fingers at all. Lots of sharp pains up and my arm, numb sensations, pins and needles and swelling around the wrist and knuckle area. My thumb and next finger are worse. At night it feels like fireworks inside my lower arm. Taking Vitamin 2. I am female aged 55 , self employed and use my computer for income - at this stage my left hand can only type with one finger. Where to now?
Tue, 27 Aug 2013
Hi, thanks for writing to HCM.
Nerve injuries are of 3 types (in the order of increasing damage)
* Neuropraxia -where nerve function is disturbed either due to compression or stretching without actual physical injury. Recovery is 100% in this case.
* Axonotmesis - where a few nerve fibres are actually severed within the nerve sheath. There is still continuation of few nerve fibres. Recovery is likely to proceed with time ranging from 3 months - 1 year.
* Neurotmesis - complete division of the nerve. Recovery by natural process is not possible and a surgical intervention is needed.
So, in your case, the type of radial nerve injury is to be established first by way of NERVE CONDUCTION studies and EMG.
As mentioned, the management depends on the type of nerve injury.
Hope this information is helpful. Good day
Nerve injuries are of 3 types (in the order of increasing damage)
* Neuropraxia -where nerve function is disturbed either due to compression or stretching without actual physical injury. Recovery is 100% in this case.
* Axonotmesis - where a few nerve fibres are actually severed within the nerve sheath. There is still continuation of few nerve fibres. Recovery is likely to proceed with time ranging from 3 months - 1 year.
* Neurotmesis - complete division of the nerve. Recovery by natural process is not possible and a surgical intervention is needed.
So, in your case, the type of radial nerve injury is to be established first by way of NERVE CONDUCTION studies and EMG.
As mentioned, the management depends on the type of nerve injury.
Hope this information is helpful. Good day
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Hello, Thanks for writing to us,
You are having traumatic radial nerve injury , I will advise to undergo some investigations like EMG- NCV study.
I t will show is there any natural nerve regeneration occuring or not.
If there is no regeneration then you can undergo nerve operation immediately , but if process of nerve regeneration is there then you can wait for progression .
Till time use dynamic wrist drop splint, continue physiotherapy, take vit B12.
I hope that I have answered your query. Let me know if I can help you further. Take care
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