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Median nerve
7%
139/2045
Anterior interosseous nerve
76%
1554/2045
Posterior interosseous nerve
13%
256/2045
Ulnar nerve
3%
62/2045
Radial nerve
1%
15/2045
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An inability to flex the thumb interphalangeal joint or the index finger distal interphalangeal joint is indicative of an anterior interosseous nerve palsy/injury. This has been reported with tension band fixation of olecranon fractures, especially with overpenetration of the anterior cortex of the proximal ulna by the Kirschner wire. Anterior interosseous nerve palsy can also be possible by overpenetration of drill bits or screws through the anterior cortex. Initial treatment of this nerve injury is observation. The referenced article by Parker et al reports a case of anterior interosseous nerve palsy after such tension band fixation. They note that this was a direct injury from the Kirchner wires. The referenced article by Adams et al reviews nerve injuries about the elbow. They note that an appreciation of the complex anatomy of the region and an understanding of treatment options are necessary for surgeons who treat elbow injuries. Figure A is a lateral radiograph of a olecranon fracture fixed with a tension band construct. Incorrect Answers: The other nerves are not associated with overpenetration of the far cortex in an olecranon tension band fixation.
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