| Popis: |
Nineteen cases of nerve complications following closed fractures of the lower end of the radius (17 lesions of the median nerve, 4 of which were associated with lesions of the ulnar nerve, and 2 isolated lesions of the ulnar) were observed. A therapeutic approach may be suggested for lesions of the median nerve and/or the ulnar nerve: immediate lesions: immediate reduction, gently if possible and avoiding the position of volar flexion and ulnar deviation. Early secondary lesions associated with immobilization in flexion and ulnar deviation: modify the position and complementary pinning when necessary. Deterioration----neurolysis: no improvement----neurolysis at the 6th month. Early secondary lesions following immobilization in a neutral position: same approach as previous case. Late cases: in absence of malunion or in presence of a minimal malunion: division of the carpal tunnel and/or Guyon's canal. Exceptionally associated fascicular neurolysis. In presence of malunion: corrective osteotomy, completed in serious cases of compression syndrome by a division of the canals. |
