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Pain sensation to the radial portion of the dorsum of the hand
3%
71/2468
Temperature sensation to the radial portion of the dorsum of the hand
6%
159/2468
Sensation of light touch to the radial portion of the dorsum of the hand
23%
571/2468
Wrist extension
65%
1600/2468
Elbow extension
1%
31/2468
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This patient sustained a humeral shaft fracture which is associated with radial nerve palsy. Motor function is also last function to return. In the case of a radial nerve injury, this is manifested in a loss of wrist extension. Peripheral nerve injury causes a loss of distal function in the following order: motor function, proprioception, light touch sensation, temperature, pain, and sympathetic activity. Nerve function recovery occurs in the reverse order. Therefore, if a patient has a nerve injury, motor function is lost first and is the last to recover. The injury this patient sustained is also known as a Holstein-Lewis fracture. Yan et al. performed a study to determine the role of precisely matching fascicles in the quick recovery of nerve function in long peripheral nerve defects. Recently tissue-engineered nerve grafts have shown potential in peripheral nerve injuries. They tested them in an animal nerve injury model to study the role of the precise matching of fascicles in the effectiveness of nerve function recovery. They found that in 6 weeks after surgery fascicle matched nerve grafting had good functional recovery and showed excellent physiological outcomes. Arbat-Plana et al. performed a study to determine the effects of forced, passive, and voluntary exercise on spinal motoneurons after peripheral nerve injury. The aim of their study was to investigate whether passive exercise is able to mimic the effects induced by forced exercise on the changes that axotomized motoneurons suffer after peripheral nerve injury. They found partial preservation of synapses only in axotomized motoneurons from animals subjected to high-intensity cycling and the ones that freely ran long distances, but not when low-intensity exercise protocols were applied. They conclude that intensity, not the time of exercise is the key element to prevent loss of perineuronal nets in motoneurons after axotomy. Figures A is an AP of the humerus demonstrating a distal-third humeral shaft fracture. Incorrect Answers: Answers 1, 2, & 3: Motor function is the first to be lost with a peripheral nerve injury, and the last to return. Answer 4: With a radial nerve injury at this level, elbow extension would be maintained.
3.8
(4)
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