The Journal of hand surgery · 2026
Pretreatment Electrodiagnostic Evaluation of the Median Nerve Following Distal Radius Fracture.
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Aydın Tahsin, Yalçın Topcuoğlu Elif, Gümüş Zülüfe, Yavuz İbrahim Alper, İnci Fatih, Ceyhan Erman
Аннотация
PURPOSE: The aim of this research was to evaluate median nerve neuropathy after distal radius fracture (DRF) using nerve conduction studies (NCSs) before and after treatment.
METHODS: This prospective follow-up study included 109 patients who were admitted to a level-1 trauma center with DRFs between July 2021 and January 2022, 52 of whom were treated nonsurgically and 57 of whom were treated surgically. Patients who were treated nonsurgically and were suitable for circumferential casting in the emergency department, patients with known median nerve pathology, and patients who underwent procedures other than volar locking plate surgery were excluded. Nerve conduction studies were performed three times: before treatment, at week 6, and at week 12. The relationships between NCS results and demographic (age and sex), therapeutic (treatment method, reduction time, and treatment time), functional (Disabilities of the Arm, Shoulder, and Hand score), and radiological data were evaluated.
RESULTS: Nerve conduction study abnormalities after DRFs were more frequently observed in older patients. In patients undergoing surgical treatment after DRFs, NCS findings indicating median nerve neuropathy were observed more frequently in pretreatment NCSs than in patients treated nonsurgically. However, this difference was not found at the 6- and 12-week NCSs. Median nerve neuropathy findings in pretreatment NCSs were seen more frequently in patients with delayed reduction, but this difference was not observed at the 6- and 12-week NCSs. Disabilities of the Arm, Shoulder, and Hand scores were higher for patients with abnormalities at the pretreatment and 12-week NCSs. There was no difference in NCS findings between radiological parameters or sex.
CONCLUSIONS: Age was a risk factor for median nerve neuropathy after DRFs. Delayed reduction was associated with median nerve neuropathy but resolved spontaneously within 6-12 weeks. Early median nerve neuropathy is more common with severe fracture types that usually require surgical intervention.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognosis IV.
METHODS: This prospective follow-up study included 109 patients who were admitted to a level-1 trauma center with DRFs between July 2021 and January 2022, 52 of whom were treated nonsurgically and 57 of whom were treated surgically. Patients who were treated nonsurgically and were suitable for circumferential casting in the emergency department, patients with known median nerve pathology, and patients who underwent procedures other than volar locking plate surgery were excluded. Nerve conduction studies were performed three times: before treatment, at week 6, and at week 12. The relationships between NCS results and demographic (age and sex), therapeutic (treatment method, reduction time, and treatment time), functional (Disabilities of the Arm, Shoulder, and Hand score), and radiological data were evaluated.
RESULTS: Nerve conduction study abnormalities after DRFs were more frequently observed in older patients. In patients undergoing surgical treatment after DRFs, NCS findings indicating median nerve neuropathy were observed more frequently in pretreatment NCSs than in patients treated nonsurgically. However, this difference was not found at the 6- and 12-week NCSs. Median nerve neuropathy findings in pretreatment NCSs were seen more frequently in patients with delayed reduction, but this difference was not observed at the 6- and 12-week NCSs. Disabilities of the Arm, Shoulder, and Hand scores were higher for patients with abnormalities at the pretreatment and 12-week NCSs. There was no difference in NCS findings between radiological parameters or sex.
CONCLUSIONS: Age was a risk factor for median nerve neuropathy after DRFs. Delayed reduction was associated with median nerve neuropathy but resolved spontaneously within 6-12 weeks. Early median nerve neuropathy is more common with severe fracture types that usually require surgical intervention.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognosis IV.