Median Nerve Displacement during Hardware Removal after Distal Radius Fractures

Abstract

Background This retrospective study aimed to evaluate median nerve displacement observed during hardware removal procedures following volar plating for distal radius fractures.

Methods We reviewed all cases involving removal of distal radial volar locking plates at our institution by two surgeons from 2016 to 2021. Plating procedures and hardware removals were performed using the flexor carpi radialis (FCR) approach. We examined the position of the median nerve at the time of hardware removal.

Results Median nerve displacement to the radial side of the FCR occurred in 17 out of 67 cases (25%). There were no significant differences in the degree of fracture severity or involved surgeons between the normal position and displaced groups.

Conclusions The median nerve may be displaced radially from the FCR during hardware removal, and care should be taken to avoid causing iatrogenic nerve injury.

Level of Evidence Level II.

Keywords

distal radius fracture - median nerve - displacement - hardware removal - volar locking plate

Ethical Approval

This study was approved by the Ethics Committee of Tachikawa General Hospital (approval no. 22–010, date of approval: July 19, 2022).

Informed Consent

There is no information (names, initials, hospital identification numbers or photographs) in the manuscript that can be used to identify patients.

Publication History

Received: 07 February 2024

Accepted: 19 September 2024

Article published online:
09 December 2024

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