Damage to the Radial Nerve after an accident
May 4, 2014 | 50,00 EUR | answered by Dr. med. Ralf Berg
Hello dear ones. In 1980, I had a serious accident (fall from a 7 meter height) and had 7 bone fractures including my pelvis and hip. I suffered an open comminuted fracture in my right elbow, which was treated with surgery. The head of the radius bone, which was completely shattered, was removed. In 1997, I experienced muscle atrophy in the right thumb saddle joint and it was discovered that the ulnar nerve was damaged. The nerve was constantly pulled over the fracture site, causing it to become thinner. As a result, the nerve was surgically moved to the side where it no longer slid over the bone. I was told that the nerve will not recover any further. A recent examination revealed that the radial nerve is also severely damaged. Three years ago, I had hand surgery on the right thumb saddle joint due to severe pain. A bone was removed but the operation did not go well (thumb wobbles without strength). Can anyone tell me if the radial nerve damage is a consequence of the accident after so many years, and what I can expect in the future? I am right-handed and all the problems are in my right arm (which is almost unusable). I am now 59 years old and very unhappy about this situation. Thank you very much.
Regarding your question: If at the time of the fall you also had injuries to your right upper arm (bruises, contusions) or any other signs of blunt trauma that were documented, these will have to be considered as consequences of the accident. The reason for this is that the nerve in the upper arm runs very close to the bone in the middle third and can be damaged by strong contusions or crush injuries. If the damage is incomplete, the effects may only occur much later.
If this was not the case, the answer depends on how the radial nerve damage was diagnosed. If it was confirmed through electroneurography, the neurologist should determine whether the changes in the ENG indicate trauma or degeneration.
Even if there was no injury to the upper arm at the time, the current loss of strength in the radial nerve may still be a consequence of the accident. If, as you described, the arm was almost unusable due to the injuries, nerve degeneration due to disuse may have occurred. Therefore, if you are not already in treatment, it is recommended to continue or start physical therapy based on neurophysiology (e.g. Bobath or Voijta) to prevent further nerve and muscle deterioration.
What can you expect in the future? There is only one main nerve in the arm, the median nerve. Since you have not described any issues with this nerve, it can be assumed that it was not damaged after so many years. If you can still move your index to middle/ring fingers well and grip with them, you should continue to do so.
Lastly, a question: Could it be that you have confused the names of the nerves? The ulnar nerve is located on the inside of the elbow, while the radial head is on the outside. The described issues with the thumb are more likely attributed to the radial nerve. Damage to the ulnar nerve would typically result in issues with the V and IV fingers, especially in their bending movement.
Feel free to ask for further clarification or provide me with more information if needed.
