30 yrs thin built female operated for ulna fracture 1 month back by me under supra clavicle block. Tourniquet time was 40 min pressure 250 developed zero movement over the wrist and fingers. Ncv EMG and MRI was done. Please comment about the prognosis


The causes of this condition cannot be pinpointed. We focus at problem at hand. The paralysed limb needs physiotherapy to keep joints supple . Night splints to prevent contracture. If it was neuropraxia,there would have been partial recovery at least by this time. So consider it as axonotemesis like picture. Axonal tube is intact. So the recovery is by 1mm per day. Reinnervation from proximal to distal. Discuss with physiotherapist on the benefits of electrical stimulation to prevent muscle atrophy. Nice fixation. Any other intervention decide by your own experience. These are guidelines that may fit in to your case. Good luck. Take the patient in to confidence. Talk to her and reassure her. Nothing good will come out of a blame game.

What was the status of wrist and fingers movement after surgery /before discharge. Any numbness or tingling sensation in fingers?

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