NERVE ENTRAPMENT AND REFLEX SYMPATHETIC DYSTROPHY AFTER FRACTURES OF THE DISTAL RADIUS

In a series of 542 conservatively-treated fractures of the distal radi us 30 patients (5,5%) developed compression neuropathy: of the median nerve (n = 23), of the ulnar nerve (n = 5), and of the radial nerve (n = 2). Three patients required decompression of the carpal tunnel, and one patient's ulnar symptoms were relieved after shortening osteotomy of the ulna. The remaining neuropathies resolved spontaneously over a period of three months. Five patients developed typical reflex sympat hetic dystrophy with diffuse pain, loss of hand function, and signific ant autonomic dysfunction. None of them had specific signs of compress ion neuropathy anteceding the development of reflex dystrophy. All fiv e had their joints mobilised under regional intravenous block combined with regional perfusion of soluble corticosteroid.