Surgical and Radiologic Anatomy

, Volume 32, Issue 3, pp 221–224 | Cite as

Anatomical basis of the risk of radial nerve injury related to the technique of external fixation applied to the distal humerus

  • Hans Clement
  • Wolfgang PichlerEmail author
  • Norbert Peter Tesch
  • Nima Heidari
  • Wolfgang Grechenig
Original Article



Stabilization of humeral shaft and elbow fractures can be achieved with an external-fixator. Reports about nerve injuries associated with this procedure are rare in literature. Purpose of this anatomical study was to examine the relation of the radial nerve to distal humeral half pins.


Percutaneous insertion of external-fixator half pins was performed in 20 upper limbs of 20 cadavers, according to established technique, laterally in the distal humerus.


Dissection of the upper limbs showed radial nerve injury in four of the 40 placed half pins. The proximal half pin impaled the nerve in one case and the distal half pin in three cases. Moreover the nerve was directly in contact with the pins in nine cases (five proximally, four distally).


Insertion of external-fixator half pins in the distal humerus can easily injure the radial nerve. Thus we advocate a larger skin incision, blunt dissection to the lateral cortex of the humerus and retraction of soft tissue during half pin insertion.


External-fixator Elbow Humerus Radial nerve injury Fracture 


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Hans Clement
    • 1
  • Wolfgang Pichler
    • 1
    Email author
  • Norbert Peter Tesch
    • 2
  • Nima Heidari
    • 3
  • Wolfgang Grechenig
    • 1
  1. 1.Department of TraumatologyMedical University of Graz (MUG)GrazAustria
  2. 2.Anatomic InstituteMedical University of GrazGrazAustria
  3. 3.Specialist Registrar Royal London RotationColchester General HospitalColchesterUK

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