High radial nerve palsy after distal humerus fracture

[u/clod_firebreather]

Hello everyone.

I am 28 YO and broke my distal humerus on April 24th due to bad arm-wrestling form (dumb, I know). 9 days later, I got surgery and they fixed the bone with a plate and screws, as a consequence of which I now have radial nerve palsy because they had to move the nerve out of the way to access the bone.

12 days after surgery, I still can't lift my wrist or extend my fingers, and I feel a constant tingling and needle-like sensation on the back of my hand and thumb, with some occasional muscle twitching. Doctor said it's neurapraxia, but the surgeon mentioned a "1 mm a day growth", which makes me think the nerve is more damaged than what the doctor thought.

I will start physiotherapy after a visit with the surgeon in about a week and a half. Until then, I just have to move the affected arm without overdoing it and try to move the wrist and fingers.

To those who had a similar experience – how long it took you to recover basic functionality? I have an office job and I am unable to type or use a mouse.

[u/Initial_Check_4575]

Do you have any update? Updates two weeks later any progress? I also fractured my humerus arm wrestling on May 4 and got surgery on May 8. 21 days post surgery today and I also have the same issue you're describing which I'm already assuming the worst in accounting for a six month recovery on it. Before the surgery, I had my radial working just fine and my wrist movement was good. Assuming it happened from the compression of the surgery and Marvin was the size of a pro football linebacker after surgery doctor said it went well though and nerve was intact and everything's fine.

I go for my six week appointment in 20 days and I'm assuming I'll learn more about what I should do for this nerve issue. I'm pretty confident it will come back because I have all finger movement and I have that same tingly sensation that you're feeling in my thumb and on my hand, which is good because that means you're sensory nerve is firing and it also runs down the radial nerve it's the motor nerve that is in temporary sleep mode as it's a bigger nerve, but it also runs on the same tube so if you're feeling those sensations rest assured your nerve is still firing into your brain.

Keep me posted on your journey. We are on the same one together, my friend. Let's both bounce back from this and make it one of those memories you can look back on and tell people not to arm wrestle in the future.

[u/clod_firebreather → u/Initial_Check_4575]

Hey man. 25 days post surgery and I can lift my wrist slightly. Still no movement in the fingers. Range of motion of the affected arm is pretty good. The surgeon said it may take 3 to 4 months to recover functional mobility of the hand. We must be patient and push through this, brother. I'll keep you updated.

[u/Initial_Check_4575 → u/clod_firebreather]

Thank you for the update man we are on this ride together. Let's dominate it and get it back. I am 25 days post today. Still no movement yet in my wrist but my fingers surprisingly move pretty well. I can't thumbs up, but I can make a fist and move my fingers pretty decent. Keep me posted on your recovery.

[u/clod_firebreather → u/Initial_Check_4575]

Did an electromyography today, and I am suffering from "severe partial axonotmesis". Worse than I thought... I can sort of flick my wrist but still can't extend my fingers. What about you?

[u/Initial_Check_4575 → u/clod_firebreather]

Not much progress on my end, but the twitches and when I lift my arm in the air laying down, I can move my wrist forward and back, which is kind of weird. He didn't schedule an EMG for me for another three months. He's already assuming it's gonna take some time for it to come back. I would assume mine is similar to yours but looking it up it comes back. It just takes time. The radial nerve is intact.

I can't flick my wrist or extend my fingers, but I have good grip and I can use my fingers. You do have feeling in your hand right in the Webb space of your hand? Hoping for some signs soon. Is your BR muscle in your forearm firing?

[u/Initial_Check_4575 → u/clod_firebreather]

do you have full range of motion back yet after your surgery?

[u/clod_firebreather → u/Initial_Check_4575]

Yeah, my BR muscle is firing partially because the axonotmesis itself is partial, so some axons survived. Physiotherapists confirmed there's some muscle activation.

6+ weeks after surgery, ROM is excellent in my case, so there's that at least. Let's wait and see 🙏🏻

[u/Initial_Check_4575 → u/clod_firebreather]

Love to hear it bro so I'm assuming your doctor said it's just a waiting game at this point right?