45 yrs M Pts has closed shaft humerus # with complete transected Radial Nerve . Platting done . What should be done now ?? Radial nerve repair or Tendon transfer . Kindlly give your expert opinions.
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Anoop R. Nair Have no second thoughts …its always primary nerve repair always in any major nerve transection injury and wait for recovery for 6-9 months ..then depending on deficits do tendon transfer. -
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Rajasekhar Rao P radial nerve repair is not encouraging but even if few muscles are re innervated we can take less tendons for future transfer -
Ashwini Sood Radial nerve being pure motor nerve ( nearly ) has the best chance of recovery in upper limb unlike ulnar and median which r mixed nerves.
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Rajasekhar Rao P http://www.ncbi.nlm.nih.gov/pubmed/11476297PubMed comprises more than 23 million citations for biomedical literature from M…Ver más
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Rajasekhar Rao P yes u do plating and do repair if you are not expert doing in repair just keep it end to end so that there wont be retraction and call plastic surgeon for next time or same day
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Vikas Saxena If you found transected radial nerve during surgery, it would have been primarily prepared then only always. There is good chance of recovery as it is pure motor nerve. By the way how much time has elapsed since then? -
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Ashwini Sood Just a thought !
# being closed and also at mid shaft is quite unlikely to cause complete transection of radial nerve. I hope it is not iatrogenic ! ! -
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Sai Prasad I had a similar case
Mode of injury was,pt arm was hit by a branch of a tree, while he was riding on a bike
Orif was done and repair of the nerve was done by a plastic surgeon
We had lot of difficulty in finding the prox.end as it got retracted higher up in the arm, which shows the severity of trauma
Pt is improving, 4months post op follow up -
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Parag Raiyani Dr Ashwini Sood sir…. u might have come across that kind of iatrogenic injuries because in this patient all extensor muscles were damaged. .. and sir if it is iatrogenic than we could have been able to find proximal end of it easily sir….
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Ashwini Sood please try to take it as a discussion.u were not able to repair the radial nerve because you could not find the proximal end ? If you had already diagnosed radial nerve injury pre-op then may be yu could have opted for posterior approach .
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Parag Raiyani I know pre op but no one can know that nerve could be transacted completely. Ok sir now what is best repair or tendon transfer ??
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Avinash Kumar yes……….. absolutely repair which is better being almost truly motor nerve and then burkhalter’s internal splinting……….and remember PT to ECRB is end to side not end to end. -
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Ashit Mehta I had a similar case with RNP in closed fr shaft humerus middle third.
I went postly never anticipating cut nerve as its not usual to get cut nerve at middle third shaft humerus. Found cut retracted nerve on table. Haf to call plastic surgron frd of mine who did primary repair.
I think incidence is much more than literature mentions because we dont document it. I did not do it and m sure all who had such cases here would not have documented it. -
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Nisarg Raninga Bhuro Sir I had a similar case # shaft humerus with primary rnp, I hv opened from post RN was intact do plating, 2 months had gone no recovery yet, started oral steroid and methycobal but still no result, now wt to do?
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