Peripheral nerve injuries: radial palsy in humeral fracture: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Peripheral nerve injuries: radial palsy in humeral fracture

Sample item

A 40-year-old has a closed mid-shaft humeral fracture and a radial nerve palsy noted at presentation. The skin is intact and the fracture is acceptably aligned. What is the usual plan for the nerve?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Observe with splintage and review; explore if no recovery after a few months

Most radial nerve palsies with a closed humeral fracture are neurapraxias or mild axonotmesis and recover spontaneously. Expectant management with a wrist splint is the norm, with electrophysiology and exploration if there is no sign of recovery after a few months.

Option by option

  • A. Amputation of the limb

    Amputation is not indicated for a nerve injury.

  • B. Immediate nerve exploration and grafting

    Early exploration is reserved for open fractures or for palsy appearing after manipulation.

  • C. Observe with splintage and review; explore if no recovery after a few months (correct)

    Correct. Most recover spontaneously, so exploration is kept for failure of recovery.

  • D. Tendon transfer on the first day

    Tendon transfers are considered only after the nerve has failed to recover.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Observe with splintage and review; explore if no recovery after a few months. Most radial nerve palsies with a closed humeral fracture are neurapraxias or mild axonotmesis and recover spontaneously.

Why is "Amputation of the limb" not the answer?

Amputation is not indicated for a nerve injury.

Why is "Immediate nerve exploration and grafting" not the answer?

Early exploration is reserved for open fractures or for palsy appearing after manipulation.

Why is "Tendon transfer on the first day" not the answer?

Tendon transfers are considered only after the nerve has failed to recover.

What concept does this question test?

It tests Peripheral nerve injuries: radial palsy in humeral fracture in Orthopaedics. Expectant management with a wrist splint is the norm, with electrophysiology and exploration if there is no sign of recovery after a few months.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Peripheral nerve injuries: radial palsy in humeral fracture?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.