Damage to the radial nerve. The radial nerve is adjacent to the humerus and therefore often suffers from fractures in the middle third. In case of damage to the radial nerve, active extension of the hand and the main phalanges of the fingers become impossible. The brush hangs. Fingers in the main phalanges are bent and hang down stepwise . Abduction of the thumb is not possible. Supination is broken. The skin sensitivity on the back and outer surfaces of the hand from the wrist joint to zone I, II and partially III metacarpal bones is impaired. A simple test allows detecting damage to the radial nerve: the patient is offered to lean on the table and keep his forearm upright. The brush and fingers hang down. If you give the patient’s hand and fingers a vertical position, and then immediately take the hand of the researcher, then the patient’s hand instantly falls.
Ulnar nerve damage
Damage to the ulnar nerve is accompanied by paralysis of the small muscles of the bone, so the V, IV, and sometimes III fingers take a claw-like position. The flexion of the main and final phalanges of the IV and especially V fingers is impaired. Adduction and dilution of all fingers is impossible (paralysis of interosseous muscles). Bringing a straightened thumb is impossible due to paralysis of the adductor muscle. Sensitivity disorders are detected on the palmar surface of the hand from the ulnar side of the wrist joint, including the palmar surface of the fifth finger and the ulnar surface of the fourth finger. On the back surface – from the wrist joint, including the entire fifth and fourth fingers (except for the radial surface of the distal phalanx) and the proximal half of the ulnar surface of the third finger.
Damage to the median nerve
Damage to the median nerve leads to paralysis of the radial flexor of the hand and the long palmar muscle. This causes the bend of the hand and its deviation to the elbow side. The pronation and flexion of the I, II, and III fingers is impaired. Sensitivity falls out on the radial side of the palmar surface of the hand, and on the back side – at the ends of I of the three middle fingers. Due to the flattening of the palm and the lack of opposition of the first finger, the brush looks like a “monkey paw”.
Femoral nerve damage
Damage to the femoral nerve leads to the absence of extension of the lower leg in the knee joint, weakening of the flexion of the thigh, atrophy of the quadriceps muscle of the thigh with loss of the knee reflex. Anesthesia develops on the anterior surface of the thigh and the anterior-inner surface of the lower leg.
Peroneal Nerve Damage
Damage to the peroneal nerve leads to the sagging of the foot down (falling or equinus foot) and inward, clinging to the ground when walking, inability to walk on the heel. Sensitive disorders occur on the outer surface of the lower leg and dorsum of the foot.
Tibial Nerve Damage
Damage to the tibial nerve causes paralysis of the muscles that flex the foot and fingers and turn the foot inward. Achilles reflex falls out. There is no sensitivity on the back surface of the lower leg, on the sole and plantar surfaces of the fingers, on the rear of their terminal phalanges. Atrophy occurs in the back of the leg muscles and in the muscles of the sole. Due to paralysis of the interosseous muscles, the foot takes the form of a claw, and as a result of contracture of the extensors takes the form of a “calcaneal” or “hollow foot”. Finger walking is not possible. When a nerve is injured, causalgia and vasomotor-secretory-trophic disorders are noted.
Sciatic nerve damage
Damage to the sciatic nerve leads to complete paralysis of the foot and fingers.
Combined damage to nerves and bones. The frequency of nerve damage in closed fractures and dislocations, according to various authors, ranges from 1.5 to 7.6%, depending on the location of the fracture or dislocation.
The mechanism of nerve damage during fractures and dislocations is often due to stretching and compression of the nerve trunks of the injured area. A complete anatomical break is rare. Possible nerve damage during surgery. The recognition of nerve trunk damage in closed injuries is based on typical neurological signs. With gunshot fractures, recognition is more difficult due to the large scale of tissue damage.