A rare case of posterior interosseous nerve palsy associated with radial head fracture.
BACKGROUND
Radial head fractures are the most common fractures occurring about the elbow in adults, but there have been few reported cases of associated nerve injury. The little-known posterior interosseous nerve travels in close proximity to the radial head and is particularly susceptible to injury.


OBJECTIVE
The objectives of this case report include raising awareness of the possibility of posterior interosseous nerve palsy after radial head fracture and reviewing the clinical assessment of the posterior interosseous nerve to exclude occult injury.


METHODS
Here we report a case of a 21-year-old man who developed a posterior interosseous nerve palsy after a fracture of the radial head sustained during a wrestling match. He also sustained frostbite to the extremity due to overaggressive icing of the injury.


CONCLUSIONS
Physicians should screen patients with radial head fractures for associated nerve injury. A thorough neurovascular examination with attention to the motor innervation patterns in the hand and wrist will help identify posterior interosseous nerve involvement. Careful discharge instructions will help prevent iatrogenic frostbite from overaggressive icing of injuries.
Serrano
Karen D
KD
Division of Emergency Medicine, Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Rebella
Gregory S
GS
Sansone
Jason M
JM
Kim
Michael K
MK
D000328:Adult; D017679:Cryotherapy / Q000009:adverse effects; D005385:Fingers / Q000294:innervation; D005627:Frostbite / Q000209:etiology; D006801:Humans; D008297:Male; D010243:Paralysis / Q000209:etiology*; D059348:Peripheral Nerve Injuries / Q000209:etiology*; D011859:Radiography; D011885:Radius Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D014953:Wrist / Q000294:innervation; D055815:Young Adult