HPI: Patient presents with a grossly deformed right upper extremity.
PE: Gross deformity of humerus, no open fracture. Unable to extend wrist. Unable to hyper-extend MP joints of fingers and unable to flex IP joint of thumb. Radial and ulnar pulses intact.
IMAGING: Multi-factorial fracture along the mid third of humerus along the expected course of the radial nerve.
DISPO (if at free standing ED): Transfer patient to ED with on-call orthopedics for definitive fixation. Reduce and splint prior to transfer.
TREATMENT: Nonoperative managment. Splinted and cast at bedside. Follow radial nerve palsy clinically for improvement.
CMC ER Residents
Disclaimer: All images and x-rays included on this blog are the sole property of CMC EM Residency and cannot be used or reproduced without written permission. Patient identifiers have been redacted/changed or patient consent has been obtained. Information contained in this blog is the opinion of the author and application of material contained in this blog is at the discretion of the practitioner to verify for accuracy.