Radial nerve injury associated with traumatic myositis ossificans in a brain injured patient.

As unrelated complications, peripheral nerve injury and heterotopic ossification (HO) are frequently observed in brain injured patients. Our case presentation is a 24-year-old man who sustained a brain injury in a motor vehicle accident. At two months postinjury he remained at a Rancho Level II and had HO identified in eight joints. Over the next several months, his cognition improved and he demonstrated active movement at the left wrist, but no movement at the right wrist. Plain radiographs and bone scan were consistent with myositis ossification posterior to the right mid-humerus and no fracture was identified. Electromyography revealed a right radial nerve injury below the branch to the triceps. Nine months postinjury, the patient had 4-/5 strength in right wrist extension. A thorough evaluation of all possible etiologies for a given impairment may lead to altered treatment and/or prognosis.