Median neuropathy in malunited fractures of the distal radius
Purpose Irritation of the median nerve is a well-characterized complication after acute fractures of the distal radius, but there is limited literature on median neuropathy in malunited fractures. The aims of our prospective study were to estimate the prevalence of the median neuropathy, explore the...
Gespeichert in:
| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2013-09, Vol.133 (9), p.1321-1327 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1327 |
|---|---|
| container_issue | 9 |
| container_start_page | 1321 |
| container_title | Archives of orthopaedic and trauma surgery |
| container_volume | 133 |
| creator | Megerle, Kai Baumgarten, Alfred Schmitt, Rainer van Schoonhoven, Jörg Prommersberger, Karl-Josef |
| description | Purpose
Irritation of the median nerve is a well-characterized complication after acute fractures of the distal radius, but there is limited literature on median neuropathy in malunited fractures. The aims of our prospective study were to estimate the prevalence of the median neuropathy, explore the relationship between radiographic findings and the condition, and investigate whether corrective osteotomy without carpal tunnel release was a sufficient treatment.
Methods
Thirty consecutive patients, who were referred to us for treatment of symptomatic distal radial malunion, underwent nerve conduction studies of both wrists by one board-certified neurologist under standardized conditions. Test results were correlated with conventional radiographic parameters (radial tilt, radial inclination, palmar shift, ulnar variance, radiolunate and capitolunate angle) and computer tomography (CT) based measurements of the cross-sectional area of the carpal tunnel. After corrective osteotomy without carpal tunnel release, 10 of 13 patients with unilateral preoperative median neuropathy agreed to an electrodiagnostic re-examination by the same neurologist.
Results
Nineteen patients demonstrated abnormal test results, but only seven patients complained about paresthesias of median-innervated fingers. There was no correlation between median neuropathy and conventional radiographic parameters. Surprisingly, the cross-sectional area of the carpal canal was significantly greater for patients with median neuropathy. Symptoms resolved in all patients after corrective osteotomy. Postoperatively, six of ten patients demonstrated improved nerve conduction studies, although only four patients demonstrated normal test results.
Discussion
There is a high rate of subclinical median neuropathy in malunited distal radial fractures that cannot be predicted by conventional radiographic parameters. Corrective osteotomy without carpal tunnel release is a sufficient treatment for neuropathy in malunited distal radius fractures. |
| doi_str_mv | 10.1007/s00402-013-1803-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1428270686</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1428270686</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-afc18fd2c02a9678faa19120e69463a0e7ec185b98ef9745ecb0f5c3016c33d13</originalsourceid><addsrcrecordid>eNp1kD1PwzAQhi0EoqXwA1hQJBaWwJ2dOPbAgCq-pCIWmC3XOdNUaVLsZOi_J1ULSEhMN9zzvnd6GDtHuEaA4iYCZMBTQJGiApHqAzbGTGSp0CgP2Ri0kKmCHEfsJMYlAHKl4ZiNuFAyw7wYs9sXKivbJA31oV3bbrFJqiZZ2bpvqo7KxAfruj5QTFqfdAtKyip2tk6CLas-nrIjb-tIZ_s5Ye8P92_Tp3T2-vg8vZulThS8S613qHzJHXCrZaG8taiRA0mdSWGBChqAfK4VeV1kObk5-NwJQOmEKFFM2NWudx3az55iZ1ZVdFTXtqG2jwYzrngBUskBvfyDLts-NMN3hnOJutAqUwOFO8qFNsZA3qxDtbJhYxDM1q3ZuTWDW7N1a_SQudg39_MVlT-Jb5kDwHdAHFbNB4Xf0_-3fgEPiILH</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2261979848</pqid></control><display><type>article</type><title>Median neuropathy in malunited fractures of the distal radius</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Megerle, Kai ; Baumgarten, Alfred ; Schmitt, Rainer ; van Schoonhoven, Jörg ; Prommersberger, Karl-Josef</creator><creatorcontrib>Megerle, Kai ; Baumgarten, Alfred ; Schmitt, Rainer ; van Schoonhoven, Jörg ; Prommersberger, Karl-Josef</creatorcontrib><description>Purpose
Irritation of the median nerve is a well-characterized complication after acute fractures of the distal radius, but there is limited literature on median neuropathy in malunited fractures. The aims of our prospective study were to estimate the prevalence of the median neuropathy, explore the relationship between radiographic findings and the condition, and investigate whether corrective osteotomy without carpal tunnel release was a sufficient treatment.
Methods
Thirty consecutive patients, who were referred to us for treatment of symptomatic distal radial malunion, underwent nerve conduction studies of both wrists by one board-certified neurologist under standardized conditions. Test results were correlated with conventional radiographic parameters (radial tilt, radial inclination, palmar shift, ulnar variance, radiolunate and capitolunate angle) and computer tomography (CT) based measurements of the cross-sectional area of the carpal tunnel. After corrective osteotomy without carpal tunnel release, 10 of 13 patients with unilateral preoperative median neuropathy agreed to an electrodiagnostic re-examination by the same neurologist.
Results
Nineteen patients demonstrated abnormal test results, but only seven patients complained about paresthesias of median-innervated fingers. There was no correlation between median neuropathy and conventional radiographic parameters. Surprisingly, the cross-sectional area of the carpal canal was significantly greater for patients with median neuropathy. Symptoms resolved in all patients after corrective osteotomy. Postoperatively, six of ten patients demonstrated improved nerve conduction studies, although only four patients demonstrated normal test results.
Discussion
There is a high rate of subclinical median neuropathy in malunited distal radial fractures that cannot be predicted by conventional radiographic parameters. Corrective osteotomy without carpal tunnel release is a sufficient treatment for neuropathy in malunited distal radius fractures.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-013-1803-9</identifier><identifier>PMID: 23864157</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Aged ; Female ; Fractures, Malunited - complications ; Handsurgery ; Humans ; Male ; Median Neuropathy - diagnosis ; Median Neuropathy - epidemiology ; Median Neuropathy - etiology ; Median Neuropathy - surgery ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopedics ; Osteotomy ; Prevalence ; Prospective Studies ; Radius - injuries ; Wrist Injuries - complications ; Young Adult</subject><ispartof>Archives of orthopaedic and trauma surgery, 2013-09, Vol.133 (9), p.1321-1327</ispartof><rights>Springer-Verlag Berlin Heidelberg 2013</rights><rights>Archives of Orthopaedic and Trauma Surgery is a copyright of Springer, (2013). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-afc18fd2c02a9678faa19120e69463a0e7ec185b98ef9745ecb0f5c3016c33d13</citedby><cites>FETCH-LOGICAL-c372t-afc18fd2c02a9678faa19120e69463a0e7ec185b98ef9745ecb0f5c3016c33d13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-013-1803-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-013-1803-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23864157$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Megerle, Kai</creatorcontrib><creatorcontrib>Baumgarten, Alfred</creatorcontrib><creatorcontrib>Schmitt, Rainer</creatorcontrib><creatorcontrib>van Schoonhoven, Jörg</creatorcontrib><creatorcontrib>Prommersberger, Karl-Josef</creatorcontrib><title>Median neuropathy in malunited fractures of the distal radius</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Purpose
Irritation of the median nerve is a well-characterized complication after acute fractures of the distal radius, but there is limited literature on median neuropathy in malunited fractures. The aims of our prospective study were to estimate the prevalence of the median neuropathy, explore the relationship between radiographic findings and the condition, and investigate whether corrective osteotomy without carpal tunnel release was a sufficient treatment.
Methods
Thirty consecutive patients, who were referred to us for treatment of symptomatic distal radial malunion, underwent nerve conduction studies of both wrists by one board-certified neurologist under standardized conditions. Test results were correlated with conventional radiographic parameters (radial tilt, radial inclination, palmar shift, ulnar variance, radiolunate and capitolunate angle) and computer tomography (CT) based measurements of the cross-sectional area of the carpal tunnel. After corrective osteotomy without carpal tunnel release, 10 of 13 patients with unilateral preoperative median neuropathy agreed to an electrodiagnostic re-examination by the same neurologist.
Results
Nineteen patients demonstrated abnormal test results, but only seven patients complained about paresthesias of median-innervated fingers. There was no correlation between median neuropathy and conventional radiographic parameters. Surprisingly, the cross-sectional area of the carpal canal was significantly greater for patients with median neuropathy. Symptoms resolved in all patients after corrective osteotomy. Postoperatively, six of ten patients demonstrated improved nerve conduction studies, although only four patients demonstrated normal test results.
Discussion
There is a high rate of subclinical median neuropathy in malunited distal radial fractures that cannot be predicted by conventional radiographic parameters. Corrective osteotomy without carpal tunnel release is a sufficient treatment for neuropathy in malunited distal radius fractures.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Fractures, Malunited - complications</subject><subject>Handsurgery</subject><subject>Humans</subject><subject>Male</subject><subject>Median Neuropathy - diagnosis</subject><subject>Median Neuropathy - epidemiology</subject><subject>Median Neuropathy - etiology</subject><subject>Median Neuropathy - surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Osteotomy</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Radius - injuries</subject><subject>Wrist Injuries - complications</subject><subject>Young Adult</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kD1PwzAQhi0EoqXwA1hQJBaWwJ2dOPbAgCq-pCIWmC3XOdNUaVLsZOi_J1ULSEhMN9zzvnd6GDtHuEaA4iYCZMBTQJGiApHqAzbGTGSp0CgP2Ri0kKmCHEfsJMYlAHKl4ZiNuFAyw7wYs9sXKivbJA31oV3bbrFJqiZZ2bpvqo7KxAfruj5QTFqfdAtKyip2tk6CLas-nrIjb-tIZ_s5Ye8P92_Tp3T2-vg8vZulThS8S613qHzJHXCrZaG8taiRA0mdSWGBChqAfK4VeV1kObk5-NwJQOmEKFFM2NWudx3az55iZ1ZVdFTXtqG2jwYzrngBUskBvfyDLts-NMN3hnOJutAqUwOFO8qFNsZA3qxDtbJhYxDM1q3ZuTWDW7N1a_SQudg39_MVlT-Jb5kDwHdAHFbNB4Xf0_-3fgEPiILH</recordid><startdate>20130901</startdate><enddate>20130901</enddate><creator>Megerle, Kai</creator><creator>Baumgarten, Alfred</creator><creator>Schmitt, Rainer</creator><creator>van Schoonhoven, Jörg</creator><creator>Prommersberger, Karl-Josef</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130901</creationdate><title>Median neuropathy in malunited fractures of the distal radius</title><author>Megerle, Kai ; Baumgarten, Alfred ; Schmitt, Rainer ; van Schoonhoven, Jörg ; Prommersberger, Karl-Josef</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-afc18fd2c02a9678faa19120e69463a0e7ec185b98ef9745ecb0f5c3016c33d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Fractures, Malunited - complications</topic><topic>Handsurgery</topic><topic>Humans</topic><topic>Male</topic><topic>Median Neuropathy - diagnosis</topic><topic>Median Neuropathy - epidemiology</topic><topic>Median Neuropathy - etiology</topic><topic>Median Neuropathy - surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Osteotomy</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Radius - injuries</topic><topic>Wrist Injuries - complications</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Megerle, Kai</creatorcontrib><creatorcontrib>Baumgarten, Alfred</creatorcontrib><creatorcontrib>Schmitt, Rainer</creatorcontrib><creatorcontrib>van Schoonhoven, Jörg</creatorcontrib><creatorcontrib>Prommersberger, Karl-Josef</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Megerle, Kai</au><au>Baumgarten, Alfred</au><au>Schmitt, Rainer</au><au>van Schoonhoven, Jörg</au><au>Prommersberger, Karl-Josef</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Median neuropathy in malunited fractures of the distal radius</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>133</volume><issue>9</issue><spage>1321</spage><epage>1327</epage><pages>1321-1327</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Purpose
Irritation of the median nerve is a well-characterized complication after acute fractures of the distal radius, but there is limited literature on median neuropathy in malunited fractures. The aims of our prospective study were to estimate the prevalence of the median neuropathy, explore the relationship between radiographic findings and the condition, and investigate whether corrective osteotomy without carpal tunnel release was a sufficient treatment.
Methods
Thirty consecutive patients, who were referred to us for treatment of symptomatic distal radial malunion, underwent nerve conduction studies of both wrists by one board-certified neurologist under standardized conditions. Test results were correlated with conventional radiographic parameters (radial tilt, radial inclination, palmar shift, ulnar variance, radiolunate and capitolunate angle) and computer tomography (CT) based measurements of the cross-sectional area of the carpal tunnel. After corrective osteotomy without carpal tunnel release, 10 of 13 patients with unilateral preoperative median neuropathy agreed to an electrodiagnostic re-examination by the same neurologist.
Results
Nineteen patients demonstrated abnormal test results, but only seven patients complained about paresthesias of median-innervated fingers. There was no correlation between median neuropathy and conventional radiographic parameters. Surprisingly, the cross-sectional area of the carpal canal was significantly greater for patients with median neuropathy. Symptoms resolved in all patients after corrective osteotomy. Postoperatively, six of ten patients demonstrated improved nerve conduction studies, although only four patients demonstrated normal test results.
Discussion
There is a high rate of subclinical median neuropathy in malunited distal radial fractures that cannot be predicted by conventional radiographic parameters. Corrective osteotomy without carpal tunnel release is a sufficient treatment for neuropathy in malunited distal radius fractures.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>23864157</pmid><doi>10.1007/s00402-013-1803-9</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0936-8051 |
| ispartof | Archives of orthopaedic and trauma surgery, 2013-09, Vol.133 (9), p.1321-1327 |
| issn | 0936-8051 1434-3916 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1428270686 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adolescent Adult Aged Female Fractures, Malunited - complications Handsurgery Humans Male Median Neuropathy - diagnosis Median Neuropathy - epidemiology Median Neuropathy - etiology Median Neuropathy - surgery Medicine Medicine & Public Health Middle Aged Orthopedics Osteotomy Prevalence Prospective Studies Radius - injuries Wrist Injuries - complications Young Adult |
| title | Median neuropathy in malunited fractures of the distal radius |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T18%3A39%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Median%20neuropathy%20in%20malunited%20fractures%20of%20the%20distal%20radius&rft.jtitle=Archives%20of%20orthopaedic%20and%20trauma%20surgery&rft.au=Megerle,%20Kai&rft.date=2013-09-01&rft.volume=133&rft.issue=9&rft.spage=1321&rft.epage=1327&rft.pages=1321-1327&rft.issn=0936-8051&rft.eissn=1434-3916&rft_id=info:doi/10.1007/s00402-013-1803-9&rft_dat=%3Cproquest_cross%3E1428270686%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2261979848&rft_id=info:pmid/23864157&rfr_iscdi=true |